+AA
Fr
Back
Evidence Summary

What is an Evidence Summary?

Key messages from scientific research that's ready to be acted on

Got It, Hide this
  • Rating:

Folic acid or B-complex vitamins may reduce risk for heart attack and stroke

Jenkins DJA, Spence JD, Giovannucci EL, et al. Supplemental Vitamins and Minerals for CVD Prevention and Treatment. J Am Coll Cardiol. 2018;71:2570-84.

Review question

Does taking vitamin or mineral supplements treat or reduce risk for heart attack, stroke, or death due to heart disease?

Background

Taking vitamin or mineral supplements may help to correct or prevent nutrient deficiencies. However, it is unclear whether supplements can treat or prevent heart attacks, strokes, or death due to heart disease.

How the review was done

179 randomized controlled trials were published up to October 2017.

The key features of the studies were:

  • multivitamins and many individual vitamins and minerals were tested;
  • supplements were compared with not taking the supplements; and
  • studies lasted 6 months or more.

What the researchers found

Compared with not taking the supplement:

  • folic acid reduced risk for heart attack, stroke, or death due to heart disease;
  • B-complex vitamins reduced risk for stroke but not other outcomes; and
  • antioxidants, beta-carotene, calcium, iron, magnesium, multivitamins, selenium, vitamin A, vitamin B3 (niacin), vitamin B6, vitamin C, vitamin D, vitamin E, and zinc did not reduce risk for any of the outcomes.

Interpretation

The reduction in risk for heart attack, stroke, or death due to heart disease by taking folic acid primarily occurred in China where foods are not routinely fortified with folic acid. It is unclear whether the same benefit would be seen in places like North America where foods are fortified with folic acid.

Conclusions

Taking folic acid or B-complex vitamins may reduce risk for heart attack, stroke, or death due to heart disease, but most supplements do not appear to provide any benefit. Eating a healthy diet that includes plant-based foods will provide most people with the vitamins and minerals required without the need for supplements.

Note: Vitamin and mineral supplements are not safe for everyone. Ask your doctor if taking supplements is a good idea for you.

Vitamins or mineral supplements vs control to prevent heart disease events

Supplements

Outcomes

Number of trials and people

Rate of events with supplements* vs control

Absolute effect of supplements

Folic acid

Heart attack, stroke, or death due to heart disease

5 trials (21,5667 people)

4.0% vs 4.9%

About 1 less person out of 100 had a heart attack, stroke, or death due to heart disease.

 

Stroke

7 trials (24,525 people)

2.5% vs 3.1%

About 1 less person out of 200 had a stroke.

B-complex vitamins

Stroke

12 trials (43,339 people)

4.5% vs 5.0%

About 1 less person out of 200 had a stroke.

*The event rates in the supplement groups was weighted. This means it may be a little different than you would expect if you just divided number of people who had an event by the number of people who were treated.




Glossary

Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.

Related Web Resources

  • Preventing deep vein thrombosis

    Evidently Cochrane
    Compression stockings help to prevent deep vein thrombosis (blood clots and swelling) after surgery. You can choose to wear thigh or knee length stockings.
  • Coronary artery disease risk screening

    Health Link B.C.
    Men over 40 and women past menopause or over 50 should get screened for coronary artery disease (CAD) every 1 to 3 years. Your risk is higher if you have diabetes, high blood pressure, abdominal obesity, kidney disease, family history of CAD or if you smoke.
  • High cholesterol: Does reducing the amount of fat in your diet help?

    Informed Health Online
    Eat less saturated fats in your diet to help prevent heart disease. Eat less meat, butter, cheese and cream to improve your health long-term.
DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

Register for free access to all Professional content

Register
Want the latest in aging research? Sign up for our email alerts.
Subscribe
© 2012 - 2019 McMaster University | 1280 Main Street West | Hamilton, Ontario L8S4L8 | +1 905-525-9140 | Terms Of Use