From the *Center for Integrative Research on Cardiovascular Aging (CIRCA), Aurora University of Wisconsin Medical Group, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI; †Cardiology Division, Banner University Medical Center, Phoenix, AZ, ‡College of Engineering, University of Wisconsin-Madison, Madison, WI; §Division of Cardiovascular Diseases, Mayo Clinic Arizona, Phoenix, AZ; and ‖Aurora Cardiovascular Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, WI.
Cardiol Rev. 2017 Nov/Dec;25(6):298-308. doi: 10.1097/CRD.0000000000000150.
Despite the knowledge that a well-balanced diet provides most of the nutritional requirements, the use of supplemental vitamins is widespread among adults in the United States. Evidence from large randomized controlled trials over the last 2 decades does not support vitamin supplementation for the reduction of cardiovascular risk factors or clinical outcomes. Many of the vitamins used in common practice likely are safe when consumed in small doses, but long-term consumption of megadoses is not only expensive but has the potential to cause adverse effects. Therefore, a need exists to revisit this issue, reminding the public and healthcare providers about the data supporting the use of vitamins for cardiovascular disease, and the potential for harm and the expense associated with their unnecessary use. In this review, we highlight the scientific evidence from randomized controlled studies regarding the efficacy and safety of vitamin supplementation for primary and secondary prevention of cardiovascular diseases and outcomes. We also draw attention to issues related to widespread and indiscriminate use of vitamin supplements and the need to educate the public to curtail unnecessary consumption and expense by limiting their use based on strong scientific evidence.
尽管人们知道均衡的饮食提供了大部分的营养需求,但补充维生素在美国成年人中仍然很普遍。过去 20 年的大型随机对照试验的证据并不支持补充维生素来降低心血管风险因素或临床结局。在常见实践中使用的许多维生素在小剂量摄入时可能是安全的,但长期服用大剂量不仅昂贵,而且有可能产生不良反应。因此,需要重新审视这个问题,提醒公众和医疗保健提供者有关维生素用于心血管疾病的数据,以及与不必要使用相关的潜在危害和费用。在这篇综述中,我们强调了随机对照研究的科学证据,这些证据涉及维生素补充剂在心血管疾病的一级和二级预防及结局方面的疗效和安全性。我们还提请注意与广泛和不加区分地使用维生素补充剂有关的问题,并呼吁教育公众根据强有力的科学证据限制维生素的使用,以减少不必要的消费和费用。