Vitamin Supplementation in Cardiovascular Disease Prevention: A Systematic Review

Abstract

Background: Cardiovascular diseases (CVD) remain the leading cause of mortality worldwide, contributing to a significant public health burden. While pharmaceutical interventions like statins are effective, the increasing interest in non-pharmaceutical approaches has sparked debates on the role of vitamin supplementation in CVD prevention. Despite some studies suggesting benefits from vitamins with antioxidant properties, evidence remains inconclusive. This review aimed to evaluate the efficacy of various vitamins in reducing CVD risk using a network meta-analysis. Methods: A systematic review and network meta-analysis were conducted on clinical trials investigating vitamin supplementation for CVD prevention. Data were sourced from MEDLINE, Embase, Cochrane, and other databases. Studies were selected based on specific criteria, including randomized controlled trials with at least six months of follow-up and reported CVD outcomes. The primary outcomes included CVD mortality and risk of heart disease, while secondary outcomes focused on stroke and myocardial infarction. A random-effects model was employed to calculate risk ratios (RR), and meta-regression analyses explored the relationship between vitamin use and lipid levels. Discussion: The analysis revealed that vitamins B, D, and E were particularly effective in reducing CVD risk. However, there was no significant added benefit from combining multiple vitamins over using individual vitamins. While niacin showed potential benefits in reducing stroke and coronary artery disease in statin-intolerant populations, its overall impact on CVD mortality was not significant. Conclusion: This review provides valuable insights into the role of vitamins in CVD prevention, demonstrating that individual vitamins like B, D, and E are effective in reducing risk, while multivitamin combinations offer no additional advantage. The lack of correlation between HDL-C changes and CVD outcomes suggests that future research should focus on other mechanisms beyond lipid management.