New research from Mass General Brigham investigators suggests that long-term multivitamin supplementation could reduce hypertension risk and blood pressure (BP) in specific groups of older adults. A secondary analysis of data from the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) found no significant effects from those randomized to daily multivitamin use versus placebo on hypertension risk or blood pressure for the overall study population. However, analyses identified small, significant improvements in study participants with lower dietary quality and normal BP at baseline. Results are published in the American Journal of Hypertension .
"Nutrition is one of the cornerstones for controlling blood pressure and hypertension. We found that a daily multivitamin might be useful for reducing the risk of hypertension in people with poorer nutritional intake," said corresponding author Rikuta Hamaya, MD, PhD, MS, of the Division of Preventive Medicine in the Mass General Brigham Department of Medicine.
"Our findings suggest that a daily multivitamin may not be a one-size-fits-all solution for controlling blood pressure but could be beneficial for important subsets of older adults," said corresponding and senior author Howard Sesso, ScD, MPH, of the Division of Preventive Medicine in the Mass General Brigham Department of Medicine.
COSMOS is a randomized, placebo-controlled clinical trial that investigated the effects of cocoa extract and multivitamin supplementation on health outcomes among older U.S. adults. In this study, the research team analyzed a subset of 8,905 older adults without hypertension at baseline, who took either Centrum Silver or placebo daily over a median window of 3.4 years. The researchers also evaluated blood pressure changes over two years in two groups of 529 and 994 participants, whose measurements were taken at a clinic or at home, respectively.
Overall, the investigators found no differences in self-reported incident hypertension between the multivitamin and placebo groups. Multivitamins lowered risk of hypertension in participants with comparatively lower diet quality, as measured by Alternative Healthy Eating Index (AHEI) and Alternate Mediterranean Diet (aMED) scores. In addition, participants with normal BP at baseline taking a daily multivitamin experienced small, significant reductions in BP measurements over two years.
The authors propose that further research is required to examine the effects of a daily multivitamin in younger and middle-aged adults, and across different populations based on nutritional status.
Authorship: In addition to Hamaya and Sesso, Mass General Brigham authors include Sidong Li, Jessica Lau, , Pamela M. Rist, and JoAnn E. Manson. Additional authors include Susanne Rautiainen, Bernhard Haring, Simin Liu, Aladdin H. Shadyab, Lisa Warsinger Martin, and Sylvia Wassertheil-Smoller.
Disclosures: Sesso and Manson received investigator-initiated grants from Mars Edge, a segment of Mars Incorporated dedicated to nutrition research and products, for infrastructure support and donation of COSMOS study pills and packaging, and Pfizer Consumer Healthcare (now Haleon) for donation of COSMOS study pills and packaging during the conduct of the study. Sesso additionally reported receiving investigator-initiated grants from Haleon and Pure Encapsulations, and honoraria and/or travel for lectures from the Council for Responsible Nutrition, BASF, and NIH during the conduct of the study. No other authors reported any conflicts of interests for this study.
Funding: The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is supported by an investigator-initiated grant from Mars Edge, a segment of Mars dedicated to nutrition research and products, which included infrastructure support and the donation of study pills and packaging. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging. COSMOS is also supported in part by grants AG050657, AG071611, EY025623, and HL157665 from the National Institutes of Health, Bethesda, MD, and an investigator-initiated grant from Haleon. Neither company had a role in the trial design or conduct, data collection, data analysis, or manuscript preparation or review. Bernhard Haring reports lecture fees from Pfizer, Bristol Myers Squibb, Inari, Daiichi Sankyo and Boehringer Ingelheim, all unrelated to this study.
Paper cited: Hamaya R et al. "Long-term effect of multivitamin supplementation on incident self-reported hypertension and blood pressure changes in the COSMOS trial" AJH DOI: 10.1093/ajh/hpaf224
