Update on vitamin supplements for the prevention of coronary disease and stroke.
Dietary antioxidants and folic acid may play a role in the pathophysiology of coronary disease and stroke. We review patient-oriented evidence on the effectiveness of supplementation with antioxidants and/or folic acid in the prevention of myocardial infarction and stroke. Observational data suggest cardiovascular benefit of vitamin E supplementation, but results of controlled clinical trials are inconsistent regarding the effect on nonfatal myocardial infarction. Moreover, studies have not shown a protective effect of vitamin E against fatal myocardial infarction and have not addressed stroke. For vitamin C and folic acid supplementation, observational data are inconsistent and controlled clinical trials are lacking. Thus, the available evidence is insufficient to recommend the routine use of vitamin E, vitamin C or folate supplements for the prevention of myocardial infarction or stroke. The evidence argues against the use of beta carotene supplements for this purpose. The costs and risks associated with these supplements are low, however, and physicians may choose to recommend vitamin E, folate and/or vitamin C supplementation pending conclusive evidence from clinical trials.
Pearce
K A
KA
University of Kentucky College of Medicine, Lexington, USA.
Boosalis
M G
MG
Yeager
B
B
D000975:Antioxidants / Q000008:administration & dosage*; D018849:Controlled Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy / Q000517:prevention & control*; D019587:Dietary Supplements; D005260:Female; D005492:Folic Acid / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D011379:Prognosis; D012680:Sensitivity and Specificity; D020521:Stroke / Q000188:drug therapy / Q000517:prevention & control*; D014810:Vitamin E / Q000008:administration & dosage*
D000975:Antioxidants; D014810:Vitamin E; D005492:Folic Acid