American Journal of Epidemiology Vol. 152, No. 2 : 149-162
Copyright © 2000 by The Johns Hopkins University School of Hygiene and Public Health
ORIGINAL CONTRIBUTIONS |
Multivitamin Use and Mortality in a Large Prospective Study
1 Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Birth Defects, Child Development, Disability and Health, Birth Defects and Pediatric Genetics Branch, Atlanta, GA.
2 Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA.
cardiovascular diseases; cerebrovascular disorders; cohort studies; folic acid; mortality; neoplasms; smoking; vitamins
Abbreviations: CI, confidence interval; CPS-II, Cancer Preventions Study II; ICD-9, International Classification of Diseases, Ninth Revision; NTD, neural tube defect; RR, relative risk.
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INTRODUCTION |
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Heart disease, cancer, and cerebrovascular diseases are the three leading causes of death in the United States, accounting for over 60 percent of age-adjusted mortality (1
). The role of vitamin supplementation in preventing cardiovascular disease and cancer remains unclear in populations that are not clinically malnourished. Observational studies have found cardiovascular disease outcomes to be inversely associated with supplements of vitamins E (23–4) and C (5). However, randomized trials have found no cardiovascular benefit from supplemental beta carotene (67–8) and a risk reduction for nonfatal myocardial infarction (not cardiovascular death) from supplemental vitamin E (8, 9). Numerous observational studies have found lower risks for a variety of cancers associated with consumption of fruits and vegetables (10). A recent prospective study in women (11) and a case-control study in men and women (12) found a reduced risk for |
MATERIALS AND METHODS |
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Study population
Mortality outcomes
Vitamin supplement information
Statistical analyses
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RESULTS |
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Ischemic heart disease and stroke mortality |
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Cancer mortality |
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All-cause mortality |
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DISCUSSION |
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Ischemic heart disease and stroke mortality
Cancer mortality
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ACKNOWLEDGMENTS |
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NOTES |
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REFERENCES |
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