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Multivitamins Linked With Reduced Risk of Heart Attack

NEW YORK, Sept. 10 -- Multivitamin/mineral supplement users may have a lower risk for myocardial infarction (MI) according to an observational study published in the August issue of the Journal of Nutrition. Multivitamin supplement use was significantly linked with a reduced risk for a first heart attack among both men (22 percent reduced risk) and women (33 percent reduced risk).


The impact of the findings are particularly notable considering that the significant reductions found in this study did not change after adjusting for lifestyle factors such as smoking, consumption of fruits and vegetables, intake of dietary fiber and level of physical activity. Female smokers were the only group where multivitamin usage provided an additional 20 percent risk reduction. Based on this population in which consumption of fruits and vegetables is relatively low and foods are not fortified with folic acid, the author reports that use of multivitamins is associated with a substantially lower risk of MI. 1

Christina Holmquist, PhD of The National Institute of Environmental Medicine in Stockholm, Sweden, culled the data from the Stockholm Heart Epidemiology Program (SHEEP), a large population-based, case-control study of subjects aged 45 to 70, all of whom resided in Sweden and had never suffered an MI. Holmquist compared the use of dietary supplements among 1,296 cases (910 men and 386 women) who had suffered a first non-fatal MI, for one year prior to the event and 1,685 controls (1,143 men, 542 women) who had still not suffered an MI, for a corresponding time period. Food frequency questionnaires provided information on the types of vitamins used, intake levels and frequency with which people were taking multivitamins.

Among the cases, 27 percent of men and 42 percent of women were regular or occasional users of dietary supplements; among the controls, these figures were 35 percent and 57 percent, respectively. Of those participants that were taking supplements, 80 percent were using multivitamins/multiminerals with estimated nutrients and mean intakes similar to the nutrients found in most basic multivitamins. Only 10 percent of those taking supplements took separate single-entity vitamin C (1,000 mg), two percent were taking vitamin E (100 mg) and smaller percentages were taking selenium (50 mcg) or B-vitamin complex (2 mg thiamin, 2 mg riboflavin, 2 mg vitamin B6).


A number of recent peer-reviewed articles also support the use of multivitamin supplementation for health maintenance. Two of the nation's leading medical journals published articles within the last two years suggesting daily multivitamin supplementation for most adults and focusing on multivitamin/mineral supplements' role in maintaining optimal health and decreasing the risk for chronic diseases.

To date, the majority of epidemiological studies regarding nutrients and cardiovascular disease have focused on the individual impact of various antioxidants, folic acid and vitamins B6 and B12 in lowering the risk for cardiovascular disease through various proposed mechanisms. Given that CVD is a multifactorial condition, the combination of nutrients in a multivitamin may prove to be the most beneficial. The Holmquist study is one of the largest population-based observational studies on the role of multivitamin/ mineral supplements in the prevention of MI, including both men and women but long-term clinical trials are needed to further confirm this relationship.(2,3,4)

* Of 33,905 people questioned about supplement use in the Third National
Health and Examination Survey, more than 11,000 reported taking at
least one vitamin or mineral supplement in the past month.
* This figure is equivalent to approximately 40 percent of the U.S.
* The highest use of vitamin and mineral supplements was among
non-Hispanic whites (42.6 percent).
* Of those taking vitamin and mineral supplements, 43 percent were male
and 57 percent were female.
* The mean age of those taking vitamin and mineral supplements was 37

To view the abstract of this study, visit

1- Holmquist, C et al. Multivitamin supplements are inversely associated
with risk of myocardial infarction in men and women - Stockholm Heart
Epidemiology Program (SHEEP). Journal of Nutrition 2003; 133: 2650-2654.
2- Fairfield KM, Fletcher RH. Vitamins for Chronic Disease Prevention in
Adults: Scientific Review JAMA 2002 287: 3116-3126.
3- Fletcher RH, Fairfield KM. Vitamins for Chronic Disease Prevention in
Adults: Clinical Applications JAMA 2002 287: 3127-3129.
4- Willett WC, Stampher MJ. What vitamins should I be taking doctor? N
Engl J Med 2001; 345:1819-1824.
5- Balluz LS, et al. Vitamin and Mineral Supplement Use in the U.S.:
Results From the Third National Health and Nutrition Examination Survey
Archives of Family Medicine, 2002;(9) 258-262.

This information is provided by the Vitamin Nutrition Information Service (VNIS). The VNIS was founded by Roche Vitamins in 1979 as a source of accurate and credible information for health professionals, educators and communicators. The VNIS monitors and disseminated vitamin research, sponsors professional symposia on current vitamin topics and generates materials to educate professionals about the roles of vitamins in health.

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