Table 1.
Major randomized controlled trials evaluating the cardiovascular benefits of supplemental vitamins and minerals.
| SUPPLEMENT | TRIAL | INTERVENTION (MEDIAN FOLLOW-UP) | RESULTS (95% CI) |
|---|---|---|---|
| Multivitamin, Multimineral (MVMM) | Physicians Health Study II (PHS II) | MVMM vs placebo (11.2 y) | Major cardiovascular events: HR 1.01; CI 0.91–1.10 |
| All-cause mortality: HR 0.94; CI 0.88–1.02 | |||
| Antioxidants | Supplémentation en Vitamines et Minéraux Antioxydants (SU.VI. MAX) | Antioxidant combination vs placebo (7.5 y) | Ischemic cardiovascular events: HR 0.97; CI 0.77–1.20 |
| All-cause mortality: HR 0.77; CI 0.57–1.00 | |||
| Folic acid | Aspirin/Folate Polyp Prevention Study (AFPPS) | Folic acid vs placebo (10 y) | Incidence of MI: 2.7% vs 1.6% (P = .28) Stroke: 1.7% vs 1.0% (P = .42) Death: 1.9% vs 3.8% (P = .09) |
| China Stroke Primary Prevention trial (CSPPT) | Enalapril daily vs enalapril plus folic acid daily (4.5 y) | Stroke: HR 0.79; CI 0.68–0.93 (P = .003) | |
| Vitamin E | Women's Health Initiative (WHS) | Vitamin E vs placebo (10 y) | Major cardiovascular events: RR 0.91; CI 0.82–1.05 |
| Cardiovascular death: RR 0.76; CI 0.59–0.98 (P = .03) | |||
| Selenium and Vitamin E Cancer Prevention Trial (SELECT) | Selenium, vitamin E, selenium plus vitamin E, or placebo (5.5 y) | Cardiovascular events: RR 0.98; CI 0.88–1.09 | |
| Death: RR 0.93; CI 0.77–1.13 | |||
| Heart Outcomes Prevention Trial (HOPE) | Vitamin E vs placebo (6 y) | Major cardiovascular events: RR 1.04; CI 0.96–1.14 | |
| Death: RR 1.00; CI 0.91–1.10 | |||
| Heart failure: RR 1.13; CI 1.01–1.26 (P = .03) | |||
| Heart Outcomes Prevention Trial—The Ongoing Outcomes (HOPE-TOO) | Vitamin E vs placebo (4 y) | Major cardiovascular events: RR 1.05, CI 0.95–1.16 | |
| Death: RR 1.02; CI 0.92–1.15 | |||
| Heart failure: RR 1.19; CI 1.05–1.35 (P = .007) | |||
| Niacin | Atherothrombosis Intervention in Metabolic Syndrome with Low HDL/High Triglycerides:Impact on Global Health Outcomes (AIM-HIGH) | Niacin plus simvastatin vs placebo plus simvastatin (2 y) | Primary end point* |
| HR 1.02; CI 0.87–1.21 | |||
| Heart Protection Study 2-Treatment of HDL to Reduce the Incidence of Vascular Events (HPS2-THRIVE) | Extended-release niacin-laropiprant vs placebo in background of statin-based low-density lipoprotein-lowering therapy (3.9 y) | Major vascular events: RR 0.96; CI 0.90–1.03 | |
| Death from any cause: RR 1.09; CI 0.99–1.21 | |||
| Beta-carotene | Alpha-Tocopherol Beta-carotene Cancer prevention study (ATBC) | Alpha-tocopherol, beta-carotene, beta-carotene plus alpha-tocopherol or placebo (6.1 y) | Mortality due to ischemic heart disease: 77.1/10,000 person years in beta-carotene arm vs 68.9/10,000 person years in placebo arm |
| Beta-Carotene and Retinol Efficacy Trial (CARET) | Beta-carotene, retinol, beta-carotene plus retinol, or placebo (4 y) | Death from any cause: RR 1.18; CI 1.02–1.37 | |
| Death from cardiovascular causes: RR 1.26; CI 0.99–1.61 |