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Cancer and cardiovascular disease are frequent health-care problems and the most frequent cause of death. Shortages of antioxidant vitamins (vitamins A, C and E, beta-carotene and folic acid) have been shown to be associated with the blood vessel changes that occur in cardiovascular disease. Other information suggests that vitamins might lower a person’s chances of developing cancer. Although recent recommendations and guidelines do not encourage routine multivitamin/mineral supplementation [1-4], many people believe that taking multivitamins might reduce their chances of developing cardiovascular disease or cancer. 

 

A recent paper from the Women’s Health Initiative (WHI) clinical trials has examined associations between multivitamin use and risk of cancer, cardiovascular disease and mortality in postmenopausal women [5]. The study included 161,808 participants from the WHI clinical trials (n = 68,132 in three overlapping trials of hormone therapy, dietary modification, and calcium and vitamin D supplements) or an observational study (n = 93,676). The median follow-ups were 8.0 years in the clinical study and 7.9 years in the observational study. A total of 41.5% of the participants used multivitamins. The following events have been documented: cancers of the breast (invasive), colon/rectum, endometrium, kidney, bladder, stomach, ovary and lung; cardiovascular disease (myocardial infarction, stroke and venous thromboembolism); and total mortality. Multivariate-adjusted analyses revealed no association of multivitamin use with risk of any cancer, with myocardial infarction (hazard ratio (HR) 0.96; 95% confidence interval (CI) 0.89–1.03), with stroke (HR 0.99; 95% CI 0.91–1.07) or with mortality (HR 1.02; 95% CI 0.97–1.07).

Author(s)

  • Martin Birkhäuser
    Basel, Switzerland

Citations

  1. Summaries for patients. Taking vitamin supplements to prevent cardiovascular disease and cancer: recommendations from the U.S. Preventive Services Task Force. Ann Intern Med 2003;139:I-76.
    http://www.ncbi.nlm.nih.gov/pubmed/12834331
  2. Morris CD, Carson S. Routine vitamin supplementation to prevent cardiovascular disease: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2003;139:56-70.
    http://www.ncbi.nlm.nih.gov/pubmed/12834320
  3. NIH State-of-the-Science Panel: National Institutes of Health State-of-the-Science Conference Statement: Multivitamin/mineral supplements and chronic disease prevention. Ann Intern Med 2006;145:364-71.
    http://www.ncbi.nlm.nih.gov/pubmed/16880454
  4. Shenkin A. Micronutrients in health and disease. Postgrad Med J 2006;82:559-67.
    http://www.ncbi.nlm.nih.gov/pubmed/16954450
  5. Neuhouser ML, Wassertheil-Smoller S, Thomson C, et al. Multivitamin use and risk of cancer and cardiovascular disease in the Womens Health Initiative cohorts. Arch Intern Med 2009;169:294-304. Published February 9, 2009.
    http://www.ncbi.nlm.nih.gov/pubmed/19204221
  6. Giovannucci E. Expanding roles of vitamin D. J Clin Endocrinol Metab 2009;94:41820. Published February 2009.
    http://www.ncbi.nlm.nih.gov/pubmed/19193916
  7. Wald NJ, Oakley GP. Should folic acid fortification be mandatory? Yes.BMJ 2007;334:1252-4.
    http://www.ncbi.nlm.nih.gov/pubmed/17569931
  8. Feskanich D, Singh V, Willett WC, Colditz GA. Vitamin A intake and hip fractures among postmenopausal women. JAMA 2002;287:47-54.
    http://www.ncbi.nlm.nih.gov/pubmed/11754708
  9. Fletcher RH, Fairfield KM. Vitamins for chronic disease prevention in adults: clinical applications. JAMA 2002;287:3127-9.
    http://www.ncbi.nlm.nih.gov/pubmed/12069676
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