title: Vitamin supplement use in a low-risk population of US male physicians and subsequent cardiovascular mortality.
abstract: BACKGROUND
  Although basic research suggests that vitamins may have an important role in the prevention of cardiovascular diseases (CVD), the data from cohort studies and clinical trials are inconclusive.
  
  
  METHODS
  This prospective cohort study was conducted among 83 639 male physicians residing in the United States who had no history of CVD or cancer. At baseline, data on use of vitamin E, ascorbic acid (vitamin C), and multivitamin supplements were provided by a self-administered questionnaire. Mortality from CVD and coronary heart disease (CHD) was assessed by death certificate review.
  
  
  RESULTS
  Use of supplements was reported by 29% of the participants. During a mean follow-up of 5.5 years, 1037 CVD deaths occurred, including 608 CHD deaths. After adjustment for several cardiovascular risk factors, supplement use was not significantly associated with total CVD or CHD mortality. For vitamin E use, the relative risks (RRs) were 0.92 (95% confidence interval [CI], 0.70-1.21) for total CVD mortality and 0.88 (95% CI, 0.61-1.27) for CHD mortality; for use of vitamin C, the RRs were 0.88 (95% CI, 0.70-1.12) for total CVD mortality and 0.86 (95% CI, 0.63-1.18) for CHD mortality; and for use of multivitamin supplements, the RRs were 1.07 (95% CI, 0.91-1.25) for total CVD mortality and 1.02 (95% CI, 0.83-1.25) for CHD mortality.
  
  
  CONCLUSIONS
  In this large cohort of apparently healthy US male physicians, self-selected supplementation with vitamin E, vitamin C, or multivitamins was not associated with a significant decrease in total CVD or CHD mortality. Data from ongoing large randomized trials will be necessary to definitely establish small potential benefits of vitamin supplements on subsequent cardiovascular risk.
authors.affiliation: Department of Internal Medicine, University Hospital of Zurich, Switzerland.
authors.forename: Jorg
authors.initials: J
authors.lastname: Muntwyler
authors.forename: Charles H
authors.initials: CH
authors.lastname: Hennekens
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: Julie E
authors.initials: JE
authors.lastname: Buring
authors.forename: J Michael
authors.initials: JM
authors.lastname: Gaziano
mesh_terms: D000328:Adult; D000368:Aged; D001205:Ascorbic Acid / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000517:prevention & control*; D015331:Cohort Studies; D016001:Confidence Intervals; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010820:Physicians / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012306:Risk; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014810:Vitamin E / Q000008:administration & dosage; D014815:Vitamins / Q000008:administration & dosage*
chemical_list: D014815:Vitamins; D014810:Vitamin E; D001205:Ascorbic Acid