1日1回のマルチビタミン摂取は男性の心血管疾患を
予防しない(LBCT-19920)

1日分のマルチビタミンを毎日摂取しても50歳以上の男性において心筋梗塞、脳卒中または
心血管死を予防できなかった
Taking a daily multivitamin daily did not prevent myocardial infarction, stroke or cardiovascular death among men 50 and older
1日1回のマルチビタミン摂取は心疾患を予防しない可能性がある。このあるトライアルの結果はAmerican Heart Association 2012年学会で発表されJAMAに掲載された。このトライアルは毎日のビタミン摂取と心血管系の健康に関して調査した初めての唯一大規模な長期臨床試験である。他の観察研究の結果は一致していない。The Randomized Trial of a Multivitamin(MVM) in the Prevention of Cardiovascular Disease in Men:The Physicians' Health Study (PHS) Ⅱは米国の50歳以上の男性医師14,641人を対象とした臨床試験である。大部分は白人であった。全参加者の半数が一般的なマルチビタミンを毎日摂取し、残りの半数はプラセボを摂取した。研究者らはこの参加医師らを平均11.2年追跡した。トライアルの追跡期間中に心血管疾患が1,700件以上発現した時点で、毎日のマルチビタミン摂取が心筋梗塞、脳卒中および心血管死などの重大な心血管イベントを減少させないことが明らかになった。毎日のマルチビタミン摂取による毒性は認められず安全な様であり、同じトライアルで最近報告された全てのがん発症を軽度低下させる効果などの他の長期マルチビタミン内服効果の可能性を考慮することも重要である、と筆者らは特筆している。
Full Text

For men 50 and older, taking a multivitamin a day may not prevent heart disease. That's the finding of researchers who presented their late-breaking clinical trial at the American Heart Association's Scientific Sessions 2012. Theirs is the first and only large-scale, long-term clinical trial examining daily multivitamin use and cardiovascular health. Other observational studies have netted inconsistent results.

The full manuscript for A Randomized Trial of a Multivitamin (MVM) in the Prevention of Cardiovascular Disease in Men: The Physicians' Health Study (PHS) Ⅱ is published in the Journal of the American Medical Association.

"Multivitamins are the most common supplement taken by at least one-third of all U.S. adults," said Howard D. Sesso, Sc.D., M.P.H., lead researcher and Associate Professor of Medicine in the Division of Preventive Medicine at Brigham & Women's Hospital in Boston, Mass. "While multivitamins are typically used to prevent vitamin and mineral deficiency, there is an unproven belief that they may have benefits on other chronic diseases, including heart attack, stroke or cardiovascular death."

The results are from the Physicians' Health Study Ⅱ, a clinical trial of 14,641 U.S. male physicians who were aged 50 years and older. Most are Caucasian. Half of all participants took a common multivitamin daily; the other half took a placebo daily.

Researchers followed the physician participants for an average 11.2 years to determine if taking the multivitamin affected the occurrence of major cardiovascular events.

"After more than 1,700 major cardiovascular disease events occurred during trial follow-up, we found that taking a daily multivitamin did not reduce their risk of major cardiovascular events, including heart attack, stroke and cardiovascular death.

"It's also important to note that taking a daily multivitamin appears to be safe, with no harm found. In addition, it's also important to consider other potential effects of long-term multivitamin use, including a modest reduction in total cancer recently reported in our trial," said J. Michael Gaziano, M.D., M.P.H., chief of the Division of Aging at Brigham and Women's Hospital, and co-author of the study.

The American Heart Association suggests that the best way to get the right nutrients is to eat a healthy, balanced diet that is high in fruits and vegetables, fiber-rich whole grains, contains oily fish twice per week, is low in saturated fat and sodium and limited in added sugars and trans fats.

It's not certain whether the findings would extend to younger men, women and other racial and ethnic groups, Sesso said.

"The majority of men in our trial appeared to have, on average, good dietary habits." he said. "The question remains about how the long-term cardiovascular effects of daily multivitamin use might change among people with a wider range of nutritional status. Other healthy habits, such as smoking cessation and increased physical activity, remain effective tools in preventing cardiovascular disease and other outcomes."

The National Institutes of Health funded the trial, along with an investigator-initiated grant from BASF Corporation. Pfizer provided the multivitamins and packaging, and DSM Nutritional Products, Inc. provided packaging.