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Association between B Vitamins Supplementation and Risk of Cardiovascular Outcomes: A Cumulative Meta-Analysis of Randomized Controlled Trials

Author

Listed:
  • Chi Zhang
  • Zhi-Yong Wang
  • Ying-Yi Qin
  • Fei-Fei Yu
  • Yu-Hao Zhou

Abstract

Background: Observational studies suggest that B vitamin supplementation reduces cardiovascular risk in adults, but this association remains controversial. This study aimed to summarize the evidence from randomized controlled trials (RCTs) investigating B vitamin supplementation for the primary or secondary prevention of major adverse cardiovascular outcomes and to perform a cumulative meta-analysis to determine the evidence base. Methodology and Principal Findings: In April 2013, we searched PubMed, Embase, and the Cochrane Library to identify relevant RCTs. We included RCTs investigating the effect of B vitamin supplementation on cardiovascular outcome. Relative risk (RR) was used to measure the effect using a random-effect model. Statistical heterogeneity scores were assessed using the Q statistic. We included data on 57,952 individuals from 24 RCTs: 12 primary prevention trials and 12 secondary prevention trials. In 23 of these trials, 10,917 major adverse cardiovascular events (MACE) occurred; in 20 trials, 7,203 deaths occurred; in 15 trials, 3,422 cardiac deaths occurred; in 19 trials, 3,623 myocardial infarctions (MI) occurred; and in 18 trials, 2,465 strokes occurred. B vitamin supplementation had little or no effect on the incidence of MACE (RR, 0.98; 95% confidence interval [CI]: 0.93–1.03; P = 0.37), total mortality (RR, 1.01; 95% CI: 0.97–1.05; P = 0.77), cardiac death (RR, 0.96; 95% CI: 0.90–1.02; P = 0.21), MI (RR, 0.99; 95% CI: 0.93–1.06; P = 0.82), or stroke (RR, 0.94; 95% CI: 0.85–1.03; P = 0.18). Conclusion/Significance: B vitamin supplementation, when used for primary or secondary prevention, is not associated with a reduction in MACE, total mortality, cardiac death, MI, or stroke.

Suggested Citation

  • Chi Zhang & Zhi-Yong Wang & Ying-Yi Qin & Fei-Fei Yu & Yu-Hao Zhou, 2014. "Association between B Vitamins Supplementation and Risk of Cardiovascular Outcomes: A Cumulative Meta-Analysis of Randomized Controlled Trials," PLOS ONE, Public Library of Science, vol. 9(9), pages 1-13, September.
    • Handle: RePEc:plo:pone00:0107060
    DOI: 10.1371/journal.pone.0107060
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    References listed on IDEAS

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    1. Yu-Hao Zhou & Jian-Yuan Tang & Mei-Jing Wu & Jian Lu & Xin Wei & Ying-Yi Qin & Chao Wang & Jin-Fang Xu & Jia He, 2011. "Effect of Folic Acid Supplementation on Cardiovascular Outcomes: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 6(9), pages 1-9, September.
    2. Chi Zhang & Feng-Ling Chi & Tian-Hao Xie & Yu-Hao Zhou, 2013. "Effect of B-vitamin Supplementation on Stroke: a Meta-Analysis of Randomized Controlled Trials," PLOS ONE, Public Library of Science, vol. 8(11), pages 1-1, November.
    3. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    4. Aurelio Tobias, 1999. "Assessing the influence of a single study in the meta-anyalysis estimate," Stata Technical Bulletin, StataCorp LP, vol. 8(47).
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