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Meta-Analysis
. 2022 Mar 18;14(6):1284.
doi: 10.3390/nu14061284.

β-Carotene Supplementation and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Jiaqi Yang  1   2 , Yulin Zhang  1 , Xiaona Na  1 , Ai Zhao  1
Affiliations
Meta-Analysis

β-Carotene Supplementation and Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Jiaqi Yang et al. Nutrients. .

Abstract

β-carotene is widely available in plant-based foods, while the efficacy of β-carotene supplementation on cardiovascular disease (CVD) risk remains controversial. Hence, we performed a systematic review and meta-analysis on randomized controlled trials to investigate the associations between β-carotene supplementation and CVD risk as well as mortality. We conducted literature searches across eight databases and screened the publications from January 1900 to March 2022 on the topic of β-carotene treatments and cardiovascular outcomes. There were 10 trials and 16 reports included in the meta-analysis with a total of 182,788 individuals enrolled in the study. Results from the random-effects models indicated that β-carotene supplementation slightly increased overall cardiovascular incidence (RR: 1.04; 95% CI: 1.00, 1.08) and was constantly associated with increased cardiovascular mortality (RR: 1.12; 95% CI: 1.04, 1.19). Subgroup analyses suggested that, when β-carotene treatments were given singly, a higher risk of cardiovascular outcomes was observed (RR: 1.06; 95% CI: 1.01, 1.12). In addition, cigarettes smoking was shown to be a risk behavior associated with increased cardiovascular incidence and mortality in the β-carotene intervention group. In sum, the evidence of this study demonstrated that β-carotene supplementation had no beneficial effects on CVD incidence and potential harmful effects on CVD mortality. Further studies on understanding the efficacy of multivitamin supplementation in nutrient-deficient or sub-optimal populations are important for developing the tolerable upper intake level for β-carotene of different age and sex groups.

Keywords: cardiovascular incidence; cardiovascular mortality; myocardial infarction; stroke; β-carotene supplements.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure A1
Figure A1
Stroke incidence after excluding the trial with female high-risk participants.
Figure A2
Figure A2
Other-cause mortality in the smoking population.
Figure A3
Figure A3
Cardiovascular incidence in male/female populations.
Figure A4
Figure A4
Cardiovascular mortality in male/female populations.
Figure A5
Figure A5
Cardiovascular incidence in healthy/at-risk populations.
Figure A6
Figure A6
Cardiovascular mortality in healthy/at-risk populations.
Figure A7
Figure A7
Cardiovascular incidence in less-smoking/smoking populations.
Figure A8
Figure A8
Cardiovascular mortality in less-smoking/smoking populations.
Figure 1
Figure 1
PRISMA Flow Diagram of the literature review.
Figure 2
Figure 2
Risk of bias of included articles.
Figure 3
Figure 3
Association of β-carotene supplementation on CVD incidence.
Figure 4
Figure 4
Association of β-carotene supplementation on myocardial infarction incidence.
Figure 5
Figure 5
Association of β-carotene supplementation on stroke incidence.
Figure 6
Figure 6
Association of β-carotene supplementation on mortality.
Figure 7
Figure 7
Subgroup analysis for the efficacy of single/combined/dose of β-carotene on cardiovascular incidence.
Figure 8
Figure 8
Subgroup analysis for the efficacy of single/combined/dose of β-carotene on cardiovascular mortality.
See this image and copyright information in PMC

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