Efficacy of vitamin and antioxidant supplements in prevention of cardiovascular disease: systematic review and meta-analysis of randomised controlled trials.
Efficacy of vitamin and antioxidant supplements in prevention of cardiovascular disease: systematic review and meta-analysis of randomised controlled trials.
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DOI：
10.1136/bmj.f10
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发表时间：
2013-01-18
期刊：
影响因子：
--
通讯作者：
Korean Meta-Analysis Study Group
中科院分区：
文献类型：
--
作者：
Myung SK;Ju W;Cho B;Oh SW;Park SM;Koo BK;Park BJ;Korean Meta-Analysis Study Group
目的评价维生素和抗氧化剂补充剂对心血管疾病的预防作用。设计随机对照试验的荟萃分析。数据来源和研究选择PubMed， EMBASE， Cochrane图书馆，Scopus， CINAHL和ClinicalTrials.gov检索于2012年6月和11月。两位作者根据预先确定的选择标准，独立审查并选择了符合条件的随机对照试验。结果从数据库及相关文献中检索到2240篇文献，最终纳入50项随机对照试验，受试者294 478人（干预组156 663人，对照组137 815人）。在50项试验的固定效应荟萃分析中，补充维生素和抗氧化剂与主要心血管事件风险的降低无关（相对风险1.00,95%置信区间0.98至1.02;I2=42%）。总的来说，在按预防类型、维生素和抗氧化剂类型、心血管结局类型、研究设计、方法质量、治疗持续时间、资金来源、补充剂提供者、对照类型、每次试验的参与者人数、补充剂单独服用或与其他补充剂联合服用进行的亚组荟萃分析中，这些补充剂没有产生有益效果。在按心血管结局类型进行的亚组荟萃分析中，维生素和抗氧化剂的补充与心绞痛风险的轻微增加有关，而低剂量维生素B6的补充与主要心血管事件风险的轻微降低有关。在每个类别的高质量随机对照试验的亚组荟萃分析中，这些有益或有害的影响消失了。此外，尽管在高质量的试验中，补充维生素B6与降低心血管死亡风险有关，补充维生素E与降低心肌梗死风险有关，但这些有益效果仅在由制药行业提供补充剂的随机对照试验中看到。结论没有证据支持使用维生素和抗氧化剂补充剂预防心血管疾病。
Objective To assess the efficacy of vitamin and antioxidant supplements in the prevention of cardiovascular diseases. Design Meta-analysis of randomised controlled trials. Data sources and study selection PubMed, EMBASE, the Cochrane Library, Scopus, CINAHL, and ClinicalTrials.gov searched in June and November 2012. Two authors independently reviewed and selected eligible randomised controlled trials, based on predetermined selection criteria. Results Out of 2240 articles retrieved from databases and relevant bibliographies, 50 randomised controlled trials with 294 478 participants (156 663 in intervention groups and 137 815 in control groups) were included in the final analyses. In a fixed effect meta-analysis of the 50 trials, supplementation with vitamins and antioxidants was not associated with reductions in the risk of major cardiovascular events (relative risk 1.00, 95% confidence interval 0.98 to 1.02; I2=42%). Overall, there was no beneficial effect of these supplements in the subgroup meta-analyses by type of prevention, type of vitamins and antioxidants, type of cardiovascular outcomes, study design, methodological quality, duration of treatment, funding source, provider of supplements, type of control, number of participants in each trial, and supplements given singly or in combination with other supplements. Among the subgroup meta-analyses by type of cardiovascular outcomes, vitamin and antioxidant supplementation was associated with a marginally increased risk of angina pectoris, while low dose vitamin B6 supplementation was associated with a slightly decreased risk of major cardiovascular events. Those beneficial or harmful effects disappeared in subgroup meta-analysis of high quality randomised controlled trials within each category. Also, even though supplementation with vitamin B6 was associated with a decreased risk of cardiovascular death in high quality trials, and vitamin E supplementation with a decreased risk of myocardial infarction, those beneficial effects were seen only in randomised controlled trials in which the supplements were supplied by the pharmaceutical industry. Conclusion There is no evidence to support the use of vitamin and antioxidant supplements for prevention of cardiovascular diseases.
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影响因子：
--
作者：
Eidelman, RS;Hollar, D;Hennekens, CH
通讯作者：
Hennekens, CH
影响因子：
120.7
作者：
Armitage, Jane M.;Bowman, Louise;Collins, Rory
通讯作者：
Collins, Rory
影响因子：
37.8
作者：
Bostom AG;Carpenter MA;Kusek JW;Levey AS;Hunsicker L;Pfeffer MA;Selhub J;Jacques PF;Cole E;Gravens-Mueller L;House AA;Kew C;McKenney JL;Pacheco-Silva A;Pesavento T;Pirsch J;Smith S;Solomon S;Weir M
通讯作者：
Weir M
影响因子：
5.8
作者：
Elamin, Mohamed B.;Abu Elnour, Nisrin O.;Montori, Victor M.
通讯作者：
Montori, Victor M.
DOI：
10.1136/bmj.b4012
发表时间：
2009-10-19
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Hartling L;Ospina M;Liang Y;Dryden DM;Hooton N;Krebs Seida J;Klassen TP
通讯作者：
Klassen TP