Vitamin Supplements and Heart Disease: What Large Trials and Task Forces Concluded
What the US Preventive Services Task Force, Cochrane reviews and large randomized trials found about vitamin supplements and heart disease in adults, including where harm was seen.
Content last updated . This page has not been medically reviewed.
If you have chest pain or pressure, sudden weakness on one side of the body, trouble speaking, or severe shortness of breath, call 911 (US) or your local emergency service now. Do not wait to see whether a vitamin helps. This page is information only. A clinician or pharmacist can say whether any supplement suits a person, especially someone with heart, kidney or liver disease or someone taking medicines.
What the main studies found
| Question | What the source found | Label |
|---|---|---|
| All vitamin and mineral trials in adults without known deficiency | A review of 84 studies for the USPSTF found little or no benefit in preventing cancer, cardiovascular disease and death. [2] | No good evidence of benefit |
| Daily multivitamin | In 14,641 male US physicians aged 50 or older, followed for a median of 11.2 years, there was no significant effect on major cardiovascular events. [3] | No good evidence of benefit (men only) |
| Vitamin D3 (cholecalciferol) | In 25,871 adults taking 2000 IU a day or placebo for a median of 5.3 years, there was no lower incidence of invasive cancer or cardiovascular events. [4] | No good evidence of benefit |
| Vitamin E | The USPSTF review found no significant link with cardiovascular events (4 trials). [2] In people with vascular disease or diabetes, 400 IU a day of natural-source vitamin E for a median of 7 years did not prevent major cardiovascular events and may raise heart failure risk. [5] | Evidence of harm in that group |
| Vitamin C | A Cochrane review included eight trials; in the largest, major cardiovascular events did not differ from placebo. [6] | No good evidence of benefit |
| Beta carotene, with or without vitamin A | Pooled trials showed a higher risk of cardiovascular death (5 trials, 94,506 people). [2] | Evidence of harm |
| Niacin added to statins | A Cochrane review of 23 trials found niacin did not reduce overall mortality, and people on it were more likely to stop treatment because of side effects. [7] In 25,673 adults with vascular disease, niacin did not significantly reduce major vascular events but increased serious adverse events. [8] | Evidence of harm |
| B vitamins to lower homocysteine | Fifteen trials (71,422 people): no difference in heart attack, but a small reduction in stroke. [9] | Mixed (see below) |
| Antioxidant supplements and death from any cause | Across 78 trials the overall effect was not significant, but in the 56 trials with low risk of bias mortality was significantly higher. [10] | Mixed |
The B-vitamin result has its own page: homocysteine, folate and B vitamins.
Frequently asked questions
Can vitamin pills prevent a heart attack?
Large trials have mostly not shown it. The USPSTF found insufficient evidence for multivitamins and single or paired nutrients, and recommended against beta carotene and vitamin E for prevention. [1]
Is a daily multivitamin good for the heart?
In a trial of 14,641 male physicians followed for a median of 11.2 years, a daily multivitamin had no significant effect on major cardiovascular events. [3] The USPSTF called the overall evidence insufficient. [1]
Does vitamin D protect the heart?
In the VITAL trial, vitamin D3 at 2000 IU a day did not give a lower incidence of cardiovascular events than placebo over a median of 5.3 years. [4]
Can any vitamin supplement harm the heart?
Some trials point to harm: beta carotene was linked with higher cardiovascular death [2], vitamin E with possible heart failure in people with vascular disease or diabetes [5], and niacin with serious adverse events. [8]
What should I ask my clinician about vitamins and heart health?
Ask whether a supplement interacts with your medicines, whether a blood test shows a deficiency worth treating, and whether it matters before surgery. A clinician or pharmacist can answer for your situation.
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
How to read the evidence labels
Labels used on this page: evidence in adequately nourished people, mixed, insufficient evidence, no good evidence of benefit, evidence of harm. Each result applies to the form, amount, group and length of follow-up tested.
Why supplement trials and food studies can disagree
Limits and uncertainty
- The USPSTF evidence review included adults without cardiovascular disease or cancer and with no known deficiencies. [2] It says nothing about treating a diagnosed deficiency; see deficiency testing and its limits.
- Several of the largest trials enrolled men only, for example the multivitamin trial above. [3]
- Omega-3 fish oil is not a vitamin. See omega-3 evidence by use.
Safety and who should ask a clinician
- Bleeding: the USPSTF review noted limited evidence that vitamin E may be linked with a higher risk of hemorrhagic stroke. [2] Ask before surgery: vitamins before surgery.
- Medicines: statins, blood thinners and blood pressure medicines can interact with supplements. See medication interactions and vitamins and blood thinners.
- Pregnancy and children: the USPSTF recommendation covered nonpregnant adults only. [1] For pregnancy see vitamins in pregnancy.
- Kidney or liver disease: ask first; see vitamins and kidney or liver disease.
- Product quality: see quality testing and certifications.
References
- Vitamin, Mineral, and Multivitamin Supplementation to Prevent Cardiovascular Disease and Cancer: US Preventive Services Task Force Recommendation Statement. JAMA 2022. PubMed abstract. Read 2026-10-23.
- Vitamin and Mineral Supplements for the Primary Prevention of Cardiovascular Disease and Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2022. PubMed abstract. Read 2026-10-23.
- Multivitamins in the prevention of cardiovascular disease in men: the Physicians' Health Study II randomized controlled trial. JAMA 2012. PubMed abstract. Read 2026-10-23.
- Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease. The New England journal of medicine 2019. PubMed abstract. Read 2026-10-23.
- Effects of long-term vitamin E supplementation on cardiovascular events and cancer: a randomized controlled trial. JAMA 2005. PubMed abstract. Read 2026-10-23.
- Vitamin C supplementation for the primary prevention of cardiovascular disease. The Cochrane database of systematic reviews 2017. PubMed abstract. Read 2026-10-23.
- Niacin for primary and secondary prevention of cardiovascular events. The Cochrane database of systematic reviews 2017. PubMed abstract. Read 2026-10-23.
- Effects of extended-release niacin with laropiprant in high-risk patients. The New England journal of medicine 2014. PubMed abstract. Read 2026-10-23.
- Homocysteine-lowering interventions for preventing cardiovascular events. The Cochrane database of systematic reviews 2017. PubMed abstract. Read 2026-10-23.
- Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. The Cochrane database of systematic reviews 2012. PubMed abstract. Read 2026-10-23.
- Supplemental Vitamins and Minerals for Cardiovascular Disease Prevention and Treatment: JACC Focus Seminar. Journal of the American College of Cardiology 2021. PubMed abstract. Read 2026-10-23.