Effect of Antioxidant Vitamin Supplementation on Cardiovascular Outcomes: A Meta-Analysis of Randomized Controlled Trials
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BACKGROUND: Antioxidant vitamin (vitamin E, beta-carotene, and vitamin C) are widely used for preventing major cardiovascular outcomes. However, the effect of antioxidant vitamin on cardiovascular events remains unclear. METHODOLOGY AND PRINCIPAL FINDINGS: We searched PubMed, EmBase, the Cochrane Central Register of Controlled Trials, and the proceedings of major conferences for relevant literature. Eligible studies were randomized controlled trials that reported on the effects of antioxidant vitamin on cardiovascular outcomes as compared to placebo. Outcomes analyzed were major cardiovascular events, myocardial infarction, stroke, cardiac death, total death, and any possible adverse events. We used the I(2) statistic to measure heterogeneity between trials and calculated risk estimates for cardiovascular outcomes with random-effect meta-analysis. Independent extraction was performed by two reviewers and consensus was reached. Of 293 identified studies, we included 15 trials reporting data on 188209 participants. These studies reported 12749 major cardiovascular events, 6699 myocardial infarction, 3749 strokes, 14122 total death, and 5980 cardiac deaths. Overall, antioxidant vitamin supplementation as compared to placebo had no effect on major cardiovascular events (RR, 1.00; 95%CI, 0.96-1.03), myocardial infarction (RR, 0.98; 95%CI, 0.92-1.04), stroke (RR, 0.99; 95%CI, 0.93-1.05), total death (RR, 1.03; 95%CI, 0.98-1.07), cardiac death (RR, 1.02; 95%CI, 0.97-1.07), revascularization (RR, 1.00; 95%CI, 0.95-1.05), total CHD (RR, 0.96; 95%CI, 0.87-1.05), angina (RR, 0.98; 95%CI, 0.90-1.07), and congestive heart failure (RR, 1.07; 95%CI, 0.96 to 1.19). CONCLUSION/SIGNIFICANCE: Antioxidant vitamin supplementation has no effect on the incidence of major cardiovascular events, myocardial infarction, stroke, total death, and cardiac death.
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Several vitamins and nutrients associate with lower CVD risk in observational studies, but trials of supplements, including folate, B-vitamins, beta-carotene, vitamin C, vitamin E, and selenium, have shown no significant effects on atherosclerosis progression or CVD events.
“Several vitamins and nutrients associate with lower CVD risk in observational studies, but trials of supplements, including folate, B-vitamins, beta-carotene, vitamin C, vitamin E, and selenium, have shown no significant effects on atherosclerosis progression or CVD events.19, 331, 332”
From Dietary and Policy Priorities for Cardiovascular Disease, Diabetes, and Obesity: A Comprehensive Review (2016) · cites this paper as [332]
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- Authors
- Ye, Y., Li, J., & Yuan, Z.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Children's Hospital of Fudan University (CN)
- Corresponding author
- Yuan, Zhongxiang
- ORCID
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-02-20
- Volume
- 8
- Issue
- 2
- Pages
- e56803
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3577664
- OpenAlex
- W1975083648
- Cited by
- 204
- References
- 59
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 15 · 2021: 22 · 2020: 11 · 2019: 28 · 2018: 19 · 2017: 11 · 2016: 20 · 2015: 17 · 2014: 14 · 2013: 9
- FWCI
- 1.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Health Sciences › Medicine › Biochemistry › Phytochemicals and Antioxidant Activities
- Keywords
- antioxidant vitamins, vitamin E, beta-carotene, vitamin C, cardiovascular outcomes, myocardial infarction, stroke, cardiovascular mortality, all-cause mortality, coronary artery disease, congestive heart failure, angina pectoris, revascularization, adverse events, vitamin supplementation, cardiovascular disease prevention, selenium, nicotinic acid, omega-3 fatty acids, statins, blood pressure
- MeSH terms
- Antioxidants, Ascorbic Acid, Cardiovascular Diseases, Humans, Risk, Vitamin E, Vitamins, Odds Ratio, Randomized Controlled Trials as Topic, Publication Bias, beta Carotene, Dietary Supplements
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