 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
SUMMARIES FOR PATIENTS
Taking Vitamin Supplements To Prevent Cardiovascular Disease and Cancer: Recommendations from the U.S. Preventive Services Task Force
1 July 2003 | Volume 139 Issue 1 | Page I-76
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the American College of Physicians.
The summary below is from the full reports titled "Routine Vitamin Supplementation To Prevent Cancer and Cardiovascular Disease: Recommendations and Rationale" and "Routine Vitamin Supplementation To Prevent Cardiovascular Disease: A Summary of the Evidence for the U.S. Preventive Services Task Force." They are in the 1 July 2003 issue of Annals of Internal Medicine (volume 139, pages 51-55 and pages 56-70). The first report was written by the U.S. Preventive Services Task Force; the second report was written by C.D. Morris and S. Carson.
What is the U.S. Preventive Services Task Force?
The U.S. Preventive Services Task Force (USPSTF) is a group of health experts that reviews published research and makes recommendations about preventive health care.
What is the problem and what is known about it so far?
Cardiovascular disease (CVD) and cancer are common problems for Americans. Shortages of antioxidant vitamins (vitamins A, C, and E; beta-carotene; and folic acid) are associated with the blood vessel changes that occur in CVD. Therefore, people have thought that taking these vitamins might reduce the chances of developing CVD. Similarly, information suggests that these vitamins might lower a person's chances of developing cancer. Many studies have examined associations between particular vitamins and CVD and cancer. The studies vary in quality, and their results often conflict.
How did the USPSTF develop these recommendations?
The USPSTF reviewed published studies to evaluate whether taking vitamins A, C, and E; beta-carotene; or folic acid (alone, in combination, or as part of a multivitamin tablet) lowers people's chances of developing CVD. The USPSTF rated the quality of each study to decide how heavily to weigh it in the recommendations. The review examining CVD appears in the 1 July 2003 issue of Annals of Internal Medicine. In addition, the USPSTF performed another review to see whether taking the same vitamins lowers a person's risk for cancer. This review is available from the Agency for Healthcare Research and Quality (http://www.preventiveservices.ahrq.gov).
What did the authors find?
The authors of the review on CVD found that the highest-quality studies did not show that vitamins consistently or meaningfully decreased CVD. The highest-quality studies assigned people at random to take either vitamin supplements or a placebo pill. Placebo pills looked like the vitamin but contained no active ingredients. In these types of studies, the groups of people are similar in all regards except for taking vitamins. A fair number of studies with weaker designs suggested an association between taking vitamins and less CVD. However, in the weaker studies, the people who took vitamins may have had healthier behavior in general, such as better eating and exercise habits. The authors of the article on vitamins and cancer found no convincing evidence that vitamins prevented cancer. In two high-quality studies, smokers taking beta-carotene supplements developed cancer more often than those who did not take beta-carotene.
What does the USPSTF suggest that patients do?
The USPSTF recommends that people do not take beta-carotene supplements to lower their chances of developing CVD or cancer. The USPSTF recommends neither for nor against taking vitamins A, C, or E; multivitamins with folic acid; or combinations of these vitamins for the primary purpose of preventing CVD or cancer.
What are the cautions related to these recommendations?
These recommendations focus only on preventing CVD or cancer. There may be other reasons that people choose to take vitamins. These recommendations do not apply to people who are known to have definite deficiencies of one of the vitamins studied.
Related articles in Annals:
This article has been cited by other articles:
|
|
 |
|
  Y. Li and H. E. Schellhorn New Developments and Novel Therapeutic Perspectives for Vitamin C J. Nutr., October 1, 2007; 137(10): 2171 - 2184. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L Prentice Clinical trials and observational studies to assess the chronic disease benefits and risks of multivitamin-multimineral supplements Am. J. Clinical Nutrition, January 1, 2007; 85(1): 308S - 313S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-Y. Huang Customized Diets for Cancer Prevention According to Genetic Polymorphisms: Are We Ready Yet? J Natl Cancer Inst, November 15, 2006; 98(22): 1590 - 1591. [Full Text] [PDF]
|
|
|
|
 |
|
 T. G.K. Bentley, W. C. Willett, M. C. Weinstein, and K. M. Kuntz Population-Level Changes in Folate Intake by Age, Gender, and Race/Ethnicity after Folic Acid Fortification Am J Public Health, November 1, 2006; 96(11): 2040 - 2047. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Bleys, E. R Miller III, R. Pastor-Barriuso, L. J Appel, and E. Guallar Vitamin-mineral supplementation and the progression of atherosclerosis: a meta-analysis of randomized controlled trials. Am. J. Clinical Nutrition, October 1, 2006; 84(4): 880 - 887. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kaul, A. A. Zadeh, and P. K. Shah Homocysteine Hypothesis for Atherothrombotic Cardiovascular Disease: Not Validated J. Am. Coll. Cardiol., September 5, 2006; 48(5): 914 - 923. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-Y. Huang, B. Caballero, S. Chang, A. J. Alberg, R. D. Semba, C. R. Schneyer, R. F. Wilson, T.-Y. Cheng, J. Vassy, G. Prokopowicz, et al. The Efficacy and Safety of Multivitamin and Mineral Supplement Use To Prevent Cancer and Chronic Disease in Adults: A Systematic Review for a National Institutes of Health State-of-the-Science Conference Ann Intern Med, September 5, 2006; 145(5): 372 - 385. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. H. Kushi, T. Byers, C. Doyle, E. V. Bandera, M. McCullough, T. Gansler, K. S. Andrews, M. J. Thun, and The American Cancer Society 2006 Nutrition and Phy American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention: Reducing the Risk of Cancer With Healthy Food Choices and Physical Activity CA Cancer J Clin, September 1, 2006; 56(5): 254 - 281. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-Y. Park, S. P. Murphy, L. R. Wilkens, J. F. Yamamoto, and L. N. Kolonel Allowing for Variations in Multivitamin Supplement Composition Improves Nutrient Intake Estimates for Epidemiologic Studies J. Nutr., May 1, 2006; 136(5): 1359 - 1364. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S G. Wannamethee, G. D. Lowe, A. Rumley, K R. Bruckdorfer, and P. H Whincup Associations of vitamin C status, fruit and vegetable intakes, and markers of inflammation and hemostasis Am. J. Clinical Nutrition, March 1, 2006; 83(3): 567 - 574. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Q Pham and R. Plakogiannis Vitamin E Supplementation in Cardiovascular Disease and Cancer Prevention: Part 1 Ann. Pharmacother., November 1, 2005; 39(11): 1870 - 1878. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Developed in Collaboration With the American Colle, Endorsed by the Heart Rhythm Society, S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure) J. Am. Coll. Cardiol., September 20, 2005; 46(6): 1116 - 1143. [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Hunt, W. T. Abraham, M. H. Chin, A. M. Feldman, G. S. Francis, T. G. Ganiats, M. Jessup, M. A. Konstam, D. M. Mancini, K. Michl, et al. ACC/AHA 2005 Guideline Update for the Diagnosis and Management of Chronic Heart Failure in the Adult--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure): Developed in Collaboration With the American College of Chest Physicians and the International Society for Heart and Lung Transplantation: Endorsed by the Heart Rhythm Society Circulation, September 20, 2005; 112(12): 1825 - 1852. [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. Lichtenstein and R. M. Russell Essential Nutrients: Food or Supplements?: Where Should the Emphasis Be? JAMA, July 20, 2005; 294(3): 351 - 358. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Matsushita, C. N. Morrell, R. J.A. Mason, M. Yamakuchi, F. A. Khanday, K. Irani, and C. J. Lowenstein Hydrogen peroxide regulation of endothelial exocytosis by inhibition of N-ethylmaleimide sensitive factor J. Cell Biol., July 4, 2005; 170(1): 73 - 79. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Deicher, F. Ziai, C. Bieglmayer, M. Schillinger, and W. H. Horl Low Total Vitamin C Plasma Level Is a Risk Factor for Cardiovascular Morbidity and Mortality in Hemodialysis Patients J. Am. Soc. Nephrol., June 1, 2005; 16(6): 1811 - 1818. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A Raji, Y.-F. Kuo, S. A. Snih, B. M Sharaf, and J. A Loera Ethnic Differences in Herb and Vitamin/Mineral Use in the Elderly Ann. Pharmacother., June 1, 2005; 39(6): 1019 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. R. Miller III, R. Pastor-Barriuso, D. Dalal, R. A. Riemersma, L. J. Appel, and E. Guallar Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality Ann Intern Med, January 4, 2005; 142(1): 37 - 46. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Atkins, J. Siegel, and J. Slutsky Making Policy When The Evidence Is In Dispute Health Aff., January 1, 2005; 24(1): 102 - 113. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. M. Kris-Etherton, A. H. Lichtenstein, B. V. Howard, D. Steinberg, J. L. Witztum, and for the Nutrition Committee of the American Heart Antioxidant Vitamin Supplements and Cardiovascular Disease Circulation, August 3, 2004; 110(5): 637 - 641. [Full Text] [PDF]
|
|
|
|
 |
|
 G. J. Hankey and J. W. Eikelboom Folic Acid-Based Multivitamin Therapy to Prevent Stroke: The Jury Is Still Out Stroke, August 1, 2004; 35(8): 1995 - 1998. [Full Text] [PDF]
|
|
|
|
|
|
P. M Ridker, N. J. Brown, D. E. Vaughan, D. G. Harrison, and J. L. Mehta Established and Emerging Plasma Biomarkers in the Prediction of First Atherothrombotic Events Circulation, June 29, 2004; 109(25_suppl_1): IV-6 - IV-19. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Navab, G. M. Ananthramaiah, S. T. Reddy, B. J. Van Lenten, B. J. Ansell, G. C. Fonarow, K. Vahabzadeh, S. Hama, G. Hough, N. Kamranpour, et al. Thematic review series: The Pathogenesis of Atherosclerosis The oxidation hypothesis of atherogenesis: the role of oxidized phospholipids and HDL J. Lipid Res., June 1, 2004; 45(6): 993 - 1007. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Other articles noted: 25 Jul 03 to 7 Nov 03 Evid. Based Nurs., January 1, 2004; 7(1): e1 - 1. [Full Text] [PDF]
|
|
|
|
 |
|
 Guidelines: Vitamins and Cardiovascular-Disease Prevention Journal Watch Cardiology, August 22, 2003; 2003(822): 2 - 2. [Full Text]
|
|
|
|
 |
|
 D. Josefson Vitamin supplements do not reduce incidence of cancer or heart disease BMJ, July 10, 2003; 327(7406): 70. [Full Text]
|
|
|
|
|
|
U.S. Preventive Services Task Force* Routine Vitamin Supplementation To Prevent Cancer and Cardiovascular Disease: Recommendations and Rationale Ann Intern Med, July 1, 2003; 139(1): 51 - 55. [Abstract] [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Article
