Daily multivitamins quietly lower blood pressure in some older adults

"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.

Inside the COSMOS Trial

COSMOS is a randomized, placebo-controlled clinical trial that examined how cocoa extract and multivitamin supplements affect health outcomes in older adults in the United States. For this analysis, researchers focused on 8,905 older adults who did not have hypertension at baseline and who were randomly assigned to take either Centrum Silver or a placebo every day. They were followed for a median of 3.4 years. The team also studied blood pressure changes over two years in two additional groups of 529 and 994 participants, with BP measurements collected either in a clinic or at home, respectively.

Across the full study population, the investigators did not find differences in self-reported new-onset hypertension between the multivitamin and placebo groups. However, when they examined diet quality, they saw that multivitamin use was linked to a lower risk of hypertension among participants with relatively poorer diets, based on scores from the Alternative Healthy Eating Index (AHEI) and Alternate Mediterranean Diet (aMED). Among participants who had normal BP at the beginning of the study and took a daily multivitamin, there were also small but significant reductions in BP measurements over the two-year period.

The authors note that additional studies are needed to assess how a daily multivitamin might affect blood pressure in younger and middle-aged adults, as well as in different populations defined by their nutritional status.

Research Team, Disclosures, and Funding

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.

Sesso and Manson received investigator-initiated grants from Mars Edge, a segment of Mars Incorporated dedicated to nutrition research and products, which provided infrastructure support and donated COSMOS study pills and packaging, and from Pfizer Consumer Healthcare (now Haleon), which also donated COSMOS study pills and packaging during the trial. Sesso additionally reported investigator-initiated grants from Haleon and Pure Encapsulations, as well as honoraria and/or travel support 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.

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 provided infrastructure support and donated study pills and packaging. Pfizer Consumer Healthcare (now Haleon) offered additional support through partial provision of study pills and packaging. COSMOS also receives partial support from grants AG050657, AG071611, EY025623, and HL157665 from the National Institutes of Health, Bethesda, MD, and from an investigator-initiated grant from Haleon. Neither Mars Edge nor Haleon had any role in trial design or conduct, data collection, data analysis, or preparation or review of the manuscript. Bernhard Haring reports lecture fees from Pfizer, Bristol Myers Squibb, Inari, Daiichi Sankyo and Boehringer Ingelheim, all unrelated to this study.