Multivitamins in the prevention of cardiovascular disease

Multivitamins are used to prevent vitamin and mineral deficiency; however there is a common belief that taking multivitamins may prevent cardiovascular disease (CVD).  This study published in the November 7, 2012 of the Journal of the American Medical Association demonstrated among this population of US male physicians that taking a daily multivitamin for more than a decade of treatment and follow-up did not reduce major cardiovascular events, including nonfatal myocardial infarction (MI), non-fatal stroke and CVD mortality.


The Physicians’ Health Study II (PHS II) is a randomized, double-blind, placebo-controlled trial investigating several different vitamins including beta-carotene, vitamin E, vitamin C and a daily multivitamin. PHS II launched in 1997 with continued treatment and follow-up through 2011. The other three arms of the study looking at beta-carotene, vitamin E and vitamin C have been previously published. This study on the use of multivitamins, was just released November 7, 2012 and is entitled “Multivitamins in the Prevention of Cardiovascular Disease in Men – The Physicians’ Health Study II Randomized Controlled Trial”


A total of 14,641 male US physicians initially aged 50 years or older, including 754 men with a history of CVD at randomization, were enrolled and randomly assigned to either receive a daily multivitamin or a placebo. Of men enrolled in PHS II, 5% had a history of MI or stroke.


Over an average follow-up of ~11 years, 1732 CV events occurred, but this rate of CV events was no higher among men taking placebo than those taking a daily multivitamin.

There was no statistically significant difference in rates of MI, all stroke, hemorrhagic stroke, ischemic stroke, congestive heart failure, angina, coronary revascularization, CVD mortality, or overall mortality.

No major differences in negative effects were seen between the group receiving the multivitamin or the placebo


There is a concern that people who think they are benefiting from taking a daily multivitamin may be less likely to participate in preventive health behaviors, such as diet and exercise that are both known to reduce the risk of cardiovascular disease. Furthermore, people with heart disease or risk factors may continue to lead unhealthy lives yet take daily vitamins supplements in the hope of reducing their risk of future problems while avoiding making the needed lifestyle changes. This distraction from effective CVD prevention is viewed as the main ‘hazard’ of daily multivitamin supplementation.

The PHS II participants as a whole, exercised regularly, ate reasonably well, and didn’t smoke so the group probably represented, on average, a well-nourished population who already have adequate or optimum intake levels of nutrients, for which supplementation may offer no benefits. Multivitamin supplementation may play a role in nutritionally at-risk populations or those with nutritional deficiencies.


The best way to determine if you are getting all the nutrients in the amounts you need for your age and gender is to have your diet assessed by a Registered Dietitian.  BetterByDesign Nutrition has several different packages to meet your needs.  Remember, that visits to a Registered Dietitian are covered by most extended benefit plans.  As well, many companies have Employment Assistance Programs (EAPs) that will cover short term visits to a Registered Dietitian.  Click on the “Assessment Options” to see the various services we offer.