Micronutrient Supplementation to Reduce Cardiovascular Risk
Journal of the American College of Cardiology: Published on December,
2022
Healthy dietary patterns are rich
in micronutrients, but their influence on cardiovascular disease (CVD) risks
has not been systematically quantified.
The goal of this study was to
provide a comprehensive and most up-to-date evidence-based map that
systematically quantifies the impact of micronutrients on CVD outcomes.
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This systematic review and
meta-analysis evaluated the existing evidence from randomized controlled trials
investigating the effect of micronutrients on cardiovascular disease (CVD) risk
factors and clinical events.
A total of 884 randomized
controlled intervention trials evaluating 27 types of micronutrients among
883,627 participants (4,895,544 person-years) were identified.
The authors found moderate- to
high-quality evidence that supplementation with n-3 fatty acid, n-6 fatty acid,
L-arginine, L-citrulline, folic acid, vitamin D, magnesium, zinc, α-lipoic
acid, coenzyme Q10, melatonin, catechin, curcumin, flavanol, genistein, and
quercetin reduced the incidence of CVD risk factors.
The micronutrients with the
strongest evidence for cardiovascular (CV) disease prevention were coenzyme
Q10, omega-3 fatty acids, and folic acid.
Micronutrients that had the
greatest effect on multiple CV risk factors included genistein, zinc,
anthocyanin, curcumin, flavonol, L-arginine, magnesium, and alpha-lipoic acid.
Coenzyme Q10 had the greatest
benefit on all-cause cardiac mortality, with a relative risk of 0.68. A recent
study published in Circulation also found coenzyme Q10 to be one of the most
effective dietary supplements for congestive heart failure.
These findings suggest that micronutrient supplementation may improve CVD risk factors and decrease the incidence of adverse clinical events.
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Background
Healthy dietary patterns are rich
in micronutrients, but their influence on cardiovascular disease (CVD) risks
has not been systematically quantified.
Objectives
The goal of this study was to
provide a comprehensive and most up-to-date evidence-based map that
systematically quantifies the impact of micronutrients on CVD outcomes.
Methods
This study comprised a systematic
review and meta-analysis of randomized controlled intervention trials of
micronutrients on CVD risk factors and clinical events.
Results
A total of 884 randomized
controlled intervention trials evaluating 27 types of micronutrients among
883,627 participants (4,895,544 person-years) were identified. Supplementation
with n-3 fatty acid, n-6 fatty acid, l-arginine, l-citrulline, folic
acid, vitamin D, magnesium, zinc, α-lipoic acid, coenzyme Q10, melatonin,
catechin, curcumin, flavanol, genistein, and quercetin showed moderate- to
high-quality evidence for reducing CVD risk factors. Specifically, n-3 fatty
acid supplementation decreased CVD mortality, myocardial infarction, and
coronary heart disease events. Folic acid supplementation decreased stroke risk,
and coenzyme Q10 supplementation decreased all-cause mortality events. Vitamin
C, vitamin D, vitamin E, and selenium showed no effect on CVD or type 2
diabetes risk. β-carotene supplementation increased all-cause mortality, CVD
mortality events, and stroke risk.
Conclusions
Supplementation of some but not all micronutrients may benefit cardiometabolic health. This study highlights the importance of micronutrient diversity and the balance of benefits and risks to promote and maintain cardiovascular health in diverse populations.
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