Title:Role of Vitamins in Cardiovascular Health: Know Your Facts-Part 2
Volume: 21
Issue: 6
Author(s): Antonis A. Manolis, Theodora A. Manolis, Helen Melita and Antonis S. Manolis*
Affiliation:
- Athens University School of Medicine, Athens, Greece
Keywords:
Vitamins, cardiovascular disease, atherosclerosis, coronary artery disease, hypertension, heart failure, stroke, endothelial dysfunction.
Abstract: Cardiovascular disease (CVD) is a major cause of morbidity/mortality world-wide, hence
preventive interventions are crucial. Observational data showing beneficial CV effects of vitamin supplements,
promoted by self-proclaimed experts, have led to ~50% of Americans using multivitamins;
this practice has culminated into a multi-billion-dollar business. However, robust evidence is lacking,
and certain vitamins might incur harm. This two-part review focuses on the attributes or concerns about
specific vitamin consumption on CVD. The evidence for indiscriminate use of multivitamins indicates
no consistent CVD benefit. Specific vitamins and/or combinations are suggested, but further supportive
evidence is needed. Data presented in Part 1 indicated that folic acid and certain B-vitamins may decrease
stroke, whereas niacin might raise mortality; beta-carotene mediates pro-oxidant effects, which
may abate the benefits from other vitamins. In Part 2, data favor the anti-oxidant effects of vitamin C
and the anti-atherogenic effects of vitamins C and E, but clinical evidence is inconsistent. Vitamin D
may provide CV protection, but data are conflicting. Vitamin K appears neutral. Thus, there are favorable
CV effects of individual vitamins (C/D), but randomized/controlled data are lacking. An important
caveat regards the potential toxicity of increased doses of fat-soluble vitamins (A/D/E/K). As emphasized
in Part 1, vitamins might benefit subjects who are antioxidant-deficient or exposed to high levels
of oxidative-stress (e.g., diabetics, smokers, and elderly), stressing the importance of targeting certain
subgroups for optimal results. Finally, by promoting CV-healthy balanced-diets, we could acquire essential
vitamins and nutrients and use supplements only for specific indications.
