BACKGROUND: Although basic research suggests that vitamins may have an important 
role in the prevention of cardiovascular diseases (CVD), the data from cohort 
studies and clinical trials are inconclusive.
METHODS: This prospective cohort study was conducted among 83 639 male 
physicians residing in the United States who had no history of CVD or cancer. At 
baseline, data on use of vitamin E, ascorbic acid (vitamin C), and multivitamin 
supplements were provided by a self-administered questionnaire. Mortality from 
CVD and coronary heart disease (CHD) was assessed by death certificate review.
RESULTS: Use of supplements was reported by 29% of the participants. During a 
mean follow-up of 5.5 years, 1037 CVD deaths occurred, including 608 CHD deaths. 
After adjustment for several cardiovascular risk factors, supplement use was not 
significantly associated with total CVD or CHD mortality. For vitamin E use, the 
relative risks (RRs) were 0.92 (95% confidence interval [CI], 0.70-1.21) for 
total CVD mortality and 0.88 (95% CI, 0.61-1.27) for CHD mortality; for use of 
vitamin C, the RRs were 0.88 (95% CI, 0.70-1.12) for total CVD mortality and 
0.86 (95% CI, 0.63-1.18) for CHD mortality; and for use of multivitamin 
supplements, the RRs were 1.07 (95% CI, 0.91-1.25) for total CVD mortality and 
1.02 (95% CI, 0.83-1.25) for CHD mortality.
CONCLUSIONS: In this large cohort of apparently healthy US male physicians, 
self-selected supplementation with vitamin E, vitamin C, or multivitamins was 
not associated with a significant decrease in total CVD or CHD mortality. Data 
from ongoing large randomized trials will be necessary to definitely establish 
small potential benefits of vitamin supplements on subsequent cardiovascular 
risk.