Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial.

This was a long-term randomized controlled trial in US male physicians aged 50 years or older enrolled in the Physicians' Health Study II. Participants were generally well nourished and predominantly white, and some had prior cardiovascular disease at baseline.

For the multivitamin arm, 7317 participants were randomized and analyzed. Men received Centrum Silver daily versus placebo; the exact dose amount and units were not specified in the source text.

Daily multivitamin use did not reduce major cardiovascular events over a mean 11.2 years of follow-up. Major cardiovascular events were 876 versus 856 with multivitamin versus placebo, with adjusted HR 1.01 (0.91-1.10; P = .91). There was no meaningful effect on total MI, stroke, cardiovascular death, or total mortality. MI death was lower overall (27 vs 43; HR 0.61, 0.38-0.995; P = .048), but the authors noted this may have been due to chance; in men without baseline CVD, MI death remained lower (HR 0.56, 0.33-0.95; P = .03).

The cohort was limited to older US male physicians, so generalizability is restricted. The multivitamin formulation was identified as Centrum Silver, but the exact dose composition was not specified in the source packet. The apparent reduction in MI death was a secondary finding and may represent a chance result; other cardiovascular endpoints were null.