Annals of Internal Medicine | Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: U.S. Preventive Services Task Force Recommendation Statement

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Annals of Internal Medicine | Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: U.S. Preventive Services Task Force Recommendation Statement

Clinical Guidelines | 25 February 2014

Vitamin, Mineral, and Multivitamin Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: U.S. Preventive Services Task Force Recommendation Statement FREE ONLINE FIRST

Virginia A. Moyer, MD, MPH, on behalf of the U.S. Preventive Services Task Force*

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Ann Intern Med. Published online 25 February 2014 doi:10.7326/M14-0198

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Abstract

Abstract | Summary of Recommendations and Evidence | Rationale | Clinical Considerations |Other Considerations | Discussion | Update of Previous USPSTF Recommendation |Recommendations of Others | Appendices | References

Description: Update of the 2003 U.S. Preventive Services Task Force (USPSTF) recommendation on vitamin supplementation to prevent cardiovascular disease or cancer.

Methods: The USPSTF reviewed the evidence on the efficacy of the use of multivitamin or mineral supplements in the general adult population for the prevention of cardiovascular disease and cancer.

Population: This recommendation applies to healthy adults without special nutritional needs (typically aged 50 years or older). It does not apply to children, women who are pregnant or may become pregnant, or persons who are chronically ill or hospitalized or have a known nutritional deficiency.

Recommendation: The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of multivitamins for the prevention of cardiovascular disease or cancer. (I statement)

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of single- or paired-nutrient supplements (except β-carotene and vitamin E) for the prevention of cardiovascular disease or cancer. (I statement)

The USPSTF recommends against the use of β-carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. (D recommendation)

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The U.S. Preventive Services Task Force (USPSTF) makes recommendations about the effectiveness of specific preventive care services for patients without related signs or symptoms.

It bases its recommendations on the evidence of both the benefits and harms of the service and an assessment of the balance. The USPSTF does not consider the costs of providing a service in this assessment.

The USPSTF recognizes that clinical decisions involve more considerations than evidence alone. Clinicians should understand the evidence but individualize decision making to the specific patient or situation. Similarly, the USPSTF notes that policy and coverage decisions involve considerations in addition to the evidence of clinical benefits and harms.

Summary of Recommendations and Evidence

Abstract | Summary of Recommendations and Evidence | Rationale | Clinical Considerations |Other Considerations | Discussion | Update of Previous USPSTF Recommendation |Recommendations of Others | Appendices | References

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of multivitamins for the prevention of cardiovascular disease or cancer. (I statement)

The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of the use of single- or paired-nutrient supplements (except β-carotene and vitamin E) for the prevention of cardiovascular disease or cancer. (I statement)

The USPSTF recommends against the use of β-carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. (D recommendation)

See the Clinical Considerations section for suggestions for practice regarding the I statements.

See the Figure for a summary of the recommendation and suggestions for clinical practice.