Role of vitamins in cardiovascular health and disease

Cardiovascular disease (CVD) is the leading cause of mortality around the world. The prevention of CVD is a main goal of health care. Vitamins, especially those with antioxidant potency, may have a role in the prevention of and therapy for CVD. Antioxidant vitamins, vitamin C, vitamin E, and carotenoids are able to decrease the rate of oxidative stress, which may have a principal role in the pathogenesis of atherosclerosis and CVD. Vitamin B 6 , vitamin B 12 , and folic acid, as well as vitamin D, also contribute to maintenance of cardiovascular health and can induce cardioprotective effects. Although most of the randomized controlled trials on vitamins failed to show the benefit of vitamin supplementation for cardiovascular outcomes, a number of observational and cohort studies, meta-analyses, and stratified analyses of large vitamin trials appeared to show an effect in some aspects of cardiovascular prevention. Moreover, many of the vitamin trials for secondary prevention are biased by use of vitamins and drugs effective for cardiovascular prevention; therefore, the conclusions drawn from them supporting the effectiveness of vitamin substitution for the prevention of CVD may be inappropriate. To summarize, there are abundant data suggesting the role of vitamins in cardiovascular health and in the primary prevention of CVD; however, examinations using new concepts and new study designs are needed to establish the effectiveness of vitamin supplementation in the therapy for