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Daily multivitamins do not reduce major CV events in men and do not affect mortality

Clinical Question:
Do daily multivitamin supplements reduce the risk of cardiovascular disease and subsequent mortality in adult men?

Bottom Line:
Daily multivitamin supplementation does not reduce the risk of major cardiovascular events in men. The risks of cardiovascular-related mortality and all-cause mortality were also not reduced by multivitamin supplementation. (LOE = 1b-)

Reference:
Sesso HD, Christen WG, Bubes V, et al. Multivitamins in the prevention of cardiovascular disease in men. The Physicians' Health Study II randomized controlled trial. JAMA 2012;308(17):1751-1760.  [PMID:23117775]

Study Design:
Randomized controlled trial (double-blinded)

Funding:
Government

Allocation:
Uncertain

Setting:
Population-based

Synopsis:
As part of the Physicians' Health Study, which evaluated various health interventions, including aspirin, vitamin E, and beta-carotene, these investigators analyzed separate data on the potential value of daily multivitamin supplements in reducing major cardiovascular disease events. Eligible men (N=14,641), 50 years or older, randomly received (uncertain allocation concealment) a common daily multivitamin supplement (Centrum Silver) or a matched placebo. Of these, 5.1% had a history of cardiovascular disease and 9.0% had a history of cancer. Approximately 40% were former smokers and only 3.6% were current smokers. Individuals masked to treatment group assignment assessed outcomes, including all cancer and mortality end points. Complete follow-up occurred for more than 98% of participants for a median of 11.2 years. Using intention-to-treat analysis, the authors report no significant effect of a daily multivitamin on major cardiovascular events, including total myocardial infarction, stroke, or cardiovascular-related mortality. There was also no significant difference in all-cause mortality. Results were similar for the subset of patients with a history of cardiovascular disease.

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