Supplementation of some micronutrients may benefit cardiovascular health, according to a meta-analysis published Dec. 5 in JACC.

Peng An, PhD, et al., systematically reviewed 884 studies available on micronutrients taken as dietary supplements and analyzed the data. More than 883,000 patients were involved in the combined studies. Specifically, the researchers looked at randomized, controlled intervention trials evaluating 27 different types of antioxidant supplements.

The researchers found strong evidence that several of the antioxidant supplements offered cardiovascular benefit. These included omega-3 fatty acid, which decreased mortality from cardiovascular disease; folic acid, which lowered stroke risk; and coenzyme Q10, an antioxidant sometimes marketed as CoQ10, which decreased all-cause mortality. Omega-6 fatty acid, L-arginine, L-citrulline, Vitamin D, magnesium, zinc, alpha-lipoic acid, melatonin, catechin, curcumin, flavanol, genistein and quercetin also showed evidence of reducing cardiovascular risk.

However, not all supplements were beneficial. Vitamin C, Vitamin D, Vitamin E and selenium showed no effect on long-term cardiovascular disease outcomes or type-2 diabetes risk. And beta carotene supplements increased all-cause mortality.

According to the researchers, the findings point to the need for more personalized, precision-based dietary interventions that involve specific combinations of beneficial supplements. In addition, further study is needed, including large, high-quality interventional trials to investigate the long-term effects of certain micronutrients on health.

"Our study highlights the importance of micronutrient diversity and the balance of health benefits and risks," said Simin Liu, MD, MS, MPH, ScD, a principal investigator for the study. "The findings could be used as the basis of future clinical trials to study specific combinations of micronutrients and their impact on cardiovascular health."

In a related editorial comment, Juan G. Gormaz, PhD, and Rodrigo Carrasco, MD, PhD, note that "although the current information opens interesting perspectives for future consolidation of some antioxidants in preventive cardiology, there is still a long way to go in terms of generating evidence." They add that "regarding routine clinical practice, these results begin to open spaces for the integration of new tools into the therapeutic arsenal aimed at cardiovascular prevention in selected populations, which could be easily accessible and, with specific exceptions, would present a low frequency of adverse effects."

Clinical Topics: Dyslipidemia, Prevention, Lipid Metabolism, Nonstatins, Statins, Diet

Keywords: Antioxidants, beta Carotene, Selenium, Cardiovascular Diseases, Catechin, Citrulline, Curcumin, Genistein, Magnesium, Melatonin, Receptors, Melatonin, Quercetin, Thioctic Acid, Risk Factors, Vitamin E, Dietary Supplements, Micronutrients, Ascorbic Acid, Vitamin D, Zinc, Stroke, Heart Disease Risk Factors, Risk Assessment, Fatty Acids, Omega-3, Fatty Acids, Omega-6, Cardiology, Folic Acid, Arginine, Diabetes Mellitus, Type 2, Randomized Controlled Trials as Topic

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