Multivitamin use and the risk of myocardial infarction: a population-based cohort of Swedish women.
BACKGROUND
Dietary supplements are widely used in industrialized countries.


OBJECTIVE
The objective was to examine the association between multivitamin use and myocardial infarction (MI) in a prospective, population-based cohort of women.


METHODS
The study included 31,671 women with no history of cardiovascular disease (CVD) and 2262 women with a history of CVD aged 49-83 y from Sweden. Women completed a self-administered questionnaire in 1997 regarding dietary supplement use, diet, and lifestyle factors. Multivitamins were estimated to contain nutrients close to recommended daily allowances: vitamin A (0.9 mg), vitamin C (60 mg), vitamin D (5 μg), vitamin E (9 mg), thiamine (1.2 mg), riboflavin (1.4 mg), vitamin B-6 (1.8 mg), vitamin B-12 (3 μg), and folic acid (400 μg).


RESULTS
During an average of 10.2 y of follow-up, 932 MI cases were identified in the CVD-free group and 269 cases in the CVD group. In the CVD-free group, use of multivitamins only, compared with no use of supplements, was associated with a multivariable-adjusted hazard ratio (HR) of 0.73 (95% CI: 0.57, 0.93). The HR for multivitamin use together with other supplements was 0.70 (95% CI: 0.57, 0.87). The HR for use of supplements other than multivitamins was 0.93 (95% CI: 0.81, 1.08). The use of multivitamins for ≥5 y was associated with an HR of 0.59 (95% CI: 0.44, 0.80). In the CVD group, use of multivitamins alone or together with other supplements was not associated with MI.


CONCLUSIONS
The use of multivitamins was inversely associated with MI, especially long-term use among women with no CVD. Further prospective studies with detailed information on the content of preparations and the duration of use are needed to confirm or refute our findings.
Rautiainen
Susanne
S
Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. susanne.rautiainen@ki.se
Akesson
Agneta
A
Levitan
Emily B
EB
Morgenstern
Ralf
R
Mittleman
Murray A
MA
Wolk
Alicja
A
D000368:Aged; D000369:Aged, 80 and over; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*; D018673:Nutrition Policy; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013548:Sweden; D014815:Vitamins / Q000627:therapeutic use*
D014815:Vitamins