Comparative efficacy of vitamin supplements on prevention of major cardiovascular disease: Systematic review with network meta-analysis

Abstract

Background: Vitamins are commonly used in the prevention of major cardiovascular disease. However, the efficacy and optimum choice remain controversial.

Objective: To compare and rank the relative efficacy among all available vitamin preparations for cardiovascular disease through a network meta-analysis.

Methods: Eligible studies were identified by searching PubMed, Embase, Medline, Cochrane library and Web of Science for randomized controlled trials. A random effects model was applied within a frequentist framework.

Results: Forty-two articles (45 comparisons, 384,248 participants), including nine vitamin interventions, were identified. Vitamin D had the highest probability of being ranked best in effectiveness (0.84 [0.72, 0.98]) on prevention of cardiovascular events. With regard to reducing death of cardiovascular disease rate, vitamin E was considered better efficacy.

Conclusions: Vitamin B, D and E could reduce the incidence of cardiovascular events to varying degrees. At the same time, the combination of vitamins can not show improvement on the efficacy.

Keywords: Cardiovascular disease; Myocardial infarction; Network meta-analysis; Stroke; Supplements; Vitamin.