Multivitamin / Multivitamin-Mineral (MVM) for Cardiovascular Disease
For preventing cardiovascular disease in generally healthy adults, daily multivitamin or multivitamin-mineral (MVM) supplements show no benefit. Large randomized trials and meta-analyses consistently find no reduction in heart attack, stroke, or cardiovascular death, so this is rated counter-evidence (Tier D).
Why this grade7-layer evidence engine
The verdict rests on convergent high-quality evidence. Two landmark double-blind RCTs were flatly null: the Physicians' Health Study II (PMID 23117775; n=14,641) found no effect on major cardiovascular events over 11.2 years (HR 1.01, 95% CI 0.91-1.10), and the COSMOS trial (PMID 35294969; n=21,442) found no reduction in composite CVD events (HR 0.98, 95% CI 0.86-1.12).
Pooled analyses agree. The Kim 2018 meta-analysis (PMID 29991644; over 2 million participants) reported CVD mortality RR 1.00 (95% CI 0.97-1.04), with confidence intervals crossing 1 for coronary and stroke outcomes. A 2018 systematic review (PMID 29852980) and the 2022 USPSTF evidence review (PMID 35767665; n=739,803) likewise found no association with cardiovascular endpoints. The benefit estimate is not merely uncertain; it is centered on zero.
Authorities concur. The American Heart Association states multivitamins do not prevent heart disease or stroke, and Cleveland Clinic notes little data supports them absent a deficiency. Harvard Health (citing PHS-II) and the NHS emphasize a balanced diet over routine supplementation. The FDA authorizes no heart-disease claim for MVM. Supplements may still be warranted to correct a diagnosed deficiency, but not as cardiovascular prevention.
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditable▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.254
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 高品質 SR/MA 顯示 positive (2 篇 > 1 negative)
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status