TY  - JOUR
T1  - Multivitamins in the prevention of cardiovascular disease in men: The physicians' health study ii randomized controlled trial
AU  - Sesso HD, Christen WG, Bubes V, et al
Y1  - 2012/11/07
N1  - 10.1001/jama.2012.14805
JO  - JAMA
SP  - 1751
EP  - 1760
VL  - 308
IS  - 17
N2  - Context 
                  Although multivitamins are used to prevent vitamin and mineral deficiency, there is a perception that multivitamins may prevent cardiovascular disease (CVD). Observational studies have shown inconsistent associations between regular multivitamin use and CVD, with no long-term clinical trials of multivitamin use.Objective 
                  To determine whether long-term multivitamin supplementation decreases the risk of major cardiovascular events among men.Design, Setting, and Participants 
                  The Physicians' Health Study II, a randomized, double-blind, placebo-controlled trial of a common daily multivitamin, began in 1997 with continued treatment and follow-up through June 1, 2011. A total of 14 641 male US physicians initially aged 50 years or older (mean, 64.3 [SD, 9.2] years), including 754 men with a history of CVD at randomization, were enrolled.Intervention 
                  Daily multivitamin or placebo.Main Outcome Measures 
                  Composite end point of major cardiovascular events, including nonfatal myocardial infarction (MI), nonfatal stroke, and CVD mortality. Secondary outcomes included MI and stroke individually.Results 
                  During a median follow-up of 11.2 (interquartile range, 10.7-13.3) years, there were 1732 confirmed major cardiovascular events. Compared with placebo, there was no significant effect of a daily multivitamin on major cardiovascular events (11.0 and 10.8 events per 1000 person-years for multivitamin vs placebo, respectively; hazard ratio [HR], 1.01; 95% CI, 0.91-1.10; P = .91). Further, a daily multivitamin had no effect on total MI (3.9 and 4.2 events per 1000 person-years; HR, 0.93; 95% CI, 0.80-1.09; P = .39), total stroke (4.1 and 3.9 events per 1000 person-years; HR, 1.06; 95% CI, 0.91-1.23; P = .48), or CVD mortality (5.0 and 5.1 events per 1000 person-years; HR, 0.95; 95% CI, 0.83-1.09; P = .47). A daily multivitamin was also not significantly associated with total mortality (HR, 0.94; 95% CI, 0.88-1.02; P = .13). The effect of a daily multivitamin on major cardiovascular events did not differ between men with or without a baseline history of CVD (P = .62 for interaction).Conclusion 
                  Among this population of US male physicians, taking a daily multivitamin did not reduce major cardiovascular events, MI, stroke, and CVD mortality after more than a decade of treatment and follow-up.Trial Registration 
                  clinicaltrials.gov Identifier: NCT00270647
SN  - 0098-7484
M3  - doi: 10.1001/jama.2012.14805
UR  - http://dx.doi.org/10.1001/jama.2012.14805
ER  -