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Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials.
Am J Clin Nutr. 2006 Oct; 84(4):880-7; quiz 954-5.AJ

Abstract

BACKGROUND

Laboratory and observational studies suggest that antioxidant and B vitamin supplementation may prevent atherosclerosis. Although trials have not shown a benefit of these supplements on clinical cardiovascular events, it is unknown whether they affect the progression of atherosclerosis as measured by imaging techniques.

OBJECTIVE

The objective was to perform a meta-analysis of randomized controlled trials of the effect of vitamin-mineral supplementation on atherosclerosis progression.

DESIGN

We searched the MEDLINE, EMBASE, and CENTRAL databases for relevant studies. No language restrictions were applied. We separately analyzed trials using antioxidants (vitamins E and C, beta-carotene, or selenium) and trials using B vitamins (folate, vitamin B-6, or vitamin B-12). The progression of atherosclerosis was evaluated by B-mode ultrasound, intravascular ultrasound, or angiography. Effect sizes were calculated for the difference in slope of atherosclerosis progression between participants assigned to supplements and those assigned to the control group.

RESULTS

In trials not involving percutaneous transluminal coronary angioplasty, the pooled effect size was -0.06 (95% CI: -0.20, 0.09; 7 trials) for antioxidants and -0.93 (95% CI: -2.11, 0.26; 4 trials) for B vitamins. In trials involving percutaneous transluminal coronary angioplasty, the pooled relative risk of restenosis was 0.82 (95% CI: 0.54, 1.26; 3 trials) for antioxidants and 0.84 (95% CI: 0.34, 2.07; 2 trials) for B vitamins.

CONCLUSION

Our meta-analysis showed no evidence of a protective effect of antioxidant or B vitamin supplements on the progression of atherosclerosis, thus providing a mechanistic explanation for their lack of effect on clinical cardiovascular events.

Authors+Show Affiliations

Department of Epidemiology, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

17023716

Citation

Bleys, Joachim, et al. "Vitamin-mineral Supplementation and the Progression of Atherosclerosis: a Meta-analysis of Randomized Controlled Trials." The American Journal of Clinical Nutrition, vol. 84, no. 4, 2006, pp. 880-7; quiz 954-5.
Bleys J, Miller ER, Pastor-Barriuso R, et al. Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials. Am J Clin Nutr. 2006;84(4):880-7; quiz 954-5.
Bleys, J., Miller, E. R., Pastor-Barriuso, R., Appel, L. J., & Guallar, E. (2006). Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials. The American Journal of Clinical Nutrition, 84(4), 880-7; quiz 954-5.
Bleys J, et al. Vitamin-mineral Supplementation and the Progression of Atherosclerosis: a Meta-analysis of Randomized Controlled Trials. Am J Clin Nutr. 2006;84(4):880-7; quiz 954-5. PubMed PMID: 17023716.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials. AU - Bleys,Joachim, AU - Miller,Edgar R,3rd AU - Pastor-Barriuso,Roberto, AU - Appel,Lawrence J, AU - Guallar,Eliseo, PY - 2006/10/7/pubmed PY - 2006/11/2/medline PY - 2006/10/7/entrez SP - 880-7; quiz 954-5 JF - The American journal of clinical nutrition JO - Am J Clin Nutr VL - 84 IS - 4 N2 - BACKGROUND: Laboratory and observational studies suggest that antioxidant and B vitamin supplementation may prevent atherosclerosis. Although trials have not shown a benefit of these supplements on clinical cardiovascular events, it is unknown whether they affect the progression of atherosclerosis as measured by imaging techniques. OBJECTIVE: The objective was to perform a meta-analysis of randomized controlled trials of the effect of vitamin-mineral supplementation on atherosclerosis progression. DESIGN: We searched the MEDLINE, EMBASE, and CENTRAL databases for relevant studies. No language restrictions were applied. We separately analyzed trials using antioxidants (vitamins E and C, beta-carotene, or selenium) and trials using B vitamins (folate, vitamin B-6, or vitamin B-12). The progression of atherosclerosis was evaluated by B-mode ultrasound, intravascular ultrasound, or angiography. Effect sizes were calculated for the difference in slope of atherosclerosis progression between participants assigned to supplements and those assigned to the control group. RESULTS: In trials not involving percutaneous transluminal coronary angioplasty, the pooled effect size was -0.06 (95% CI: -0.20, 0.09; 7 trials) for antioxidants and -0.93 (95% CI: -2.11, 0.26; 4 trials) for B vitamins. In trials involving percutaneous transluminal coronary angioplasty, the pooled relative risk of restenosis was 0.82 (95% CI: 0.54, 1.26; 3 trials) for antioxidants and 0.84 (95% CI: 0.34, 2.07; 2 trials) for B vitamins. CONCLUSION: Our meta-analysis showed no evidence of a protective effect of antioxidant or B vitamin supplements on the progression of atherosclerosis, thus providing a mechanistic explanation for their lack of effect on clinical cardiovascular events. SN - 0002-9165 UR - https://www.unboundmedicine.com/medline/citation/17023716/Vitamin_mineral_supplementation_and_the_progression_of_atherosclerosis:_a_meta_analysis_of_randomized_controlled_trials_ L2 - https://academic.oup.com/ajcn/article-lookup/doi/10.1093/ajcn/84.4.880 DB - PRIME DP - Unbound Medicine ER -