Certain nutritional supplements and dietary interventions may reduce the risk for some cardiovascular outcomes in adults; however, the overall effect of nutritional supplements on cardiovascular disease outcomes remains unclear, according to a review published online in the Annals of Internal Medicine.

Safi U. Khan, M.D., from West Virginia University in Morgantown, and colleagues selected nine systematic reviews and four new randomized controlled trials that encompassed 277 trials, 24 interventions, and 992,129 participants to examine the effects of nutritional supplements and dietary interventions on mortality and cardiovascular outcomes. Overall, 105 meta-analyses were generated.

The researchers found moderate-certainty evidence that lower salt intake reduced the risk for all-cause mortality in normotensive participants and cardiovascular mortality in hypertensive participants (risk ratios [RRs], 0.90 and 0.67, respectively). Omega-3 long-chain polyunsaturated fatty acid correlated with a reduced risk for myocardial infarction and coronary heart disease based on low-certainty evidence (RRs, 0.92 and 0.93, respectively). Folic acid correlated with a reduced stroke risk (low certainty evidence; RR, 0.80), while an increased risk for stroke was seen with calcium plus vitamin D (moderate certainty evidence; RR, 1.17). No significant effect on mortality or cardiovascular outcomes was seen for other nutritional supplements or dietary interventions.

"Unfortunately, the current study leaves us with the same foggy conditions that we started with," write the authors of an accompanying editorial. "Until these conditions clear, it would be reasonable to hold off on any supplement or diet modification in all guidelines and recommendations." One author disclosed financial ties to the pharmaceutical industry.

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