Routine vitamin supplementation to prevent cardiovascular disease: a summary of the evidence for the U.S. Preventive Services Task Force

Article Abstract:

Background: Antioxidant vitamins are thought to play a role in atherosclerosis. Supplementation of these nutrients has been explored as a means of reducing cardiovascular morbidity and mortality. Purpose: To assess the evidence of the effectiveness of vitamin supplementation, specifically vitamins A, C, and E; beta-carotene; folic acid; antioxidant combinations; and multivitamin supplements, in preventing cardiovascular disease. Data Sources: Cochrane Controlled Trials Registry and MEDLINE (1966 to September 2001), reference lists, and experts. Study Selection: The researchers selected English-language reports of randomized trials and cohort studies that assessed vitamin supplementation in western populations and reported incidence of or death from cardiovascular events. They also included reports of good- or fair-quality clinical trials of primary and secondary prevention and good- or fair-quality prospective cohort studies. Studies that examined only dietary nutrients or did not provide separate estimates for supplements were not included. Data Extraction: Two reviewers abstracted descriptive information and data on cardiovascular outcomes and mortality from included studies. The researchers assessed study quality using predetermined criteria. Data Synthesis: Evidence tables were constructed to summarize data from included studies. The researchers summarized the strength, level, and quality of the overall evidence for the effectiveness of each of the vitamin supplements in preventing or treating cardiovascular disease. Conclusions: Some good-quality cohort studies have reported an association between the use of vitamin supplements and lower risk for cardiovascular disease. Randomized, controlled trials of specific supplements, however, have failed to demonstrate a consistent or significant effect of any single vitamin or combination of vitamins on incidence of or death from cardiovascular disease. Understanding the sources of these differences will permit researches to better analyze the cohort study data and to better design long-term clinical trials.

Health aspects, Reports, Nutritional aspects, Author Abstract, Multivitamins

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Cardiovascular complications of diabetes mellitus: what we know and what we need to know about their prevention

Article Abstract:

Future studies on patients with diabetes should address the effects on heart disease by aggressively managing blood sugar levels, blood pressure, cholesterol, and blood clotting. Recent studies have shown that aggressively managing blood sugar levels can reduce the incidence of small vessel disease in patients with insulin-dependent-diabetes mellitus (IDDM). Future research should evaluate whether similar control is beneficial for large vessel and heart disease as well as for patients with non-insulin-dependent diabetes mellitus (NIDDM). These studies should also include comparisons of therapies that aim to minimize the risk associated with high blood pressure, low levels of high-density lipoprotein cholesterol, abnormal blood clotting, and obesity. It is also advisable to include and compare patients from certain ethnic and racial populations.

Complications and side effects, Diabetes, Diabetes mellitus

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Screening women and elderly adults for family and intimate partner violence: a review of the evidence for the U.S. Preventive Services Task Force

Article Abstract:

The purpose is to examine evidence on the benefits and harms of screening women and elderly adults in health care settings for family and intimate partner violence. It is concluded that although the literature on family and intimate partner violence is extensive, few studies provide data on detection and management to guide clinicians.

Legal issues & crime, Government regulation (cont), Government regulation, Services information, Legal/Government Regulation, Laws, regulations and rules, Services, Medical screening, Health screening, Family health

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