Vitamines et minéraux supplémentaires pour la prévention et le traitement des maladies cardiovasculaires.

Jenkins DJA
Spence JD
Giovannucci EL
Kim YI
Josse R
Vieth R, et al.

J Am Coll Cardiol. 2018 Jun 5;71(22):2570-2584. doi: 10.1016/j.jacc.2018.04.020. (Review)
PMID: 29852980

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Disciplines

Médecine interne (voir sous-spécialités ci-dessous)

Relevance - 6/7
Intérêt médiatique - 6/7
Médecine familiale (MF)/Médecine générale (MG)

Relevance - 6/7
Intérêt médiatique - 5/7
Médecine interne générale - Soins primaires

Relevance - 6/7
Intérêt médiatique - 5/7
Santé publique

Relevance - 6/7
Intérêt médiatique - 5/7
- Cardiologie

Relevance - 5/7
Intérêt médiatique - 4/7

Résumé (en anglais)

The authors identified individual randomized controlled trials from previous meta-analyses and additional searches, and then performed meta-analyses on cardiovascular disease outcomes and all-cause mortality. The authors assessed publications from 2012, both before and including the U.S. Preventive Service Task Force review. Their systematic reviews and meta-analyses showed generally moderate- or low-quality evidence for preventive benefits (folic acid for total cardiovascular disease, folic acid and B-vitamins for stroke), no effect (multivitamins, vitamins C, D, ß-carotene, calcium, and selenium), or increased risk (antioxidant mixtures and niacin [with a statin] for all-cause mortality). Conclusive evidence for the benefit of any supplement across all dietary backgrounds (including deficiency and sufficiency) was not demonstrated; therefore, any benefits seen must be balanced against possible risks.

Commentaires cliniques (en anglais)

Cardiology

Useful article to gain more knowledge on the most current evidence behind vitamins and CVD risk. I was pleasantly surprised to learn about recently demonstrated benefits of folate in a Chinese population; however, this will need to be tested in the US. Also, it was useful to learn about potential dangers of niacin therapy in combination with statin and the need for closer monitoring of these patients.

General Internal Medicine-Primary Care(US)

The outcome of interest for this review is CVD prevention and treatment. Vitamins and minerals may affect other outcomes of interest, but only CVD outcomes are addressed here. The review indicates folate is probably helpful, but not other vitamins / minerals. This is very useful for counseling patients.

General Internal Medicine-Primary Care(US)

This is a meta-analysis / systematic review of other meta-analyses / systematic reviews related to the benefits of vitamin supplementation. It is primarily focused on the prevention of heart and vascular disease. The methodology as presented is sound and appropriate.

Internal Medicine

It's important to re-evaluate widely used supplements.

Internal Medicine

Many people take multivitamin supplements without scientifically proven justification. Some of them take formulations with higher then recommended daily allowance. The USPSTF recommends against beta-carotene or vitamin E supplementation for the prevention of cancer or cardiovascular disease, and yet many doctors continue to recommend them and many people continue to take them. Advertisements and publications in lay press (many of them written by scientists and physicians) accelerate this phenomenon of "routine" vitamin supplementation. This systematic review summarizes current evidence of clinically relevant questions related to vitamin supplementation.

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