By Morgan Nwanguma
Growing evidence suggests that a daily multivitamin may quietly support blood pressure control in some older adults particularly those with poorer diets and normal readings at baseline. Although no overall benefit was seen across the full study population, notable improvements emerged within specific subgroups, pointing to a subtle but potentially important role for micronutrient deficiencies in the development of hypertension.
In a new analysis from researchers at Mass General Brigham, long-term multivitamin use was linked to modest reductions in blood pressure and hypertension risk among select older adults. The investigators conducted a secondary analysis of the COcoa Supplement and Multivitamin Outcomes Study (COSMOS). Across all participants, there were no significant differences in blood pressure or hypertension risk between the multivitamin and placebo groups. However, among individuals with lower-quality diets and normal blood pressure at the outset, the researchers observed small yet statistically significant benefits. The findings were 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.
Inside the COSMOS Trial
COSMOS is a randomized, placebo-controlled clinical trial designed to evaluate the health effects of cocoa extract and multivitamin supplementation in older adults across the United States. For this analysis, researchers examined data from 8,905 participants who were free of hypertension at baseline and were randomly assigned to take either Centrum Silver or a placebo each day. Participants were followed for a median of 3.4 years. The investigators also assessed changes in blood pressure over a two-year period in two smaller cohorts—529 participants with clinic-based BP measurements and 994 participants who recorded BP at home.
Across the overall study population, no differences were found in self-reported new-onset hypertension between those taking a multivitamin and those receiving a placebo. However, subgroup analyses revealed that multivitamin use was associated with a lower risk of developing hypertension among participants with poorer diet quality, as measured by the Alternative Healthy Eating Index (AHEI) and the Alternate Mediterranean Diet (aMED) scores. In addition, among participants who began the study with normal blood pressure, daily multivitamin use was linked to small but statistically significant reductions in BP over the two-year follow-up.
The authors emphasize that further research is needed to determine whether these findings extend to younger and middle-aged adults and to populations with different nutritional profiles.
Research Team, Disclosures, and Funding
Alongside Hamaya and Sesso, the Mass General Brigham research team included Sidong Li, Jessica Lau, Pamela M. Rist, and JoAnn E. Manson. Additional collaborators were Susanne Rautiainen, Bernhard Haring, Simin Liu, Aladdin H. Shadyab, Lisa Warsinger Martin, and Sylvia Wassertheil-Smoller.
Sesso and Manson reported receiving investigator-initiated grants from Mars Edge, a division of Mars Incorporated focused on nutrition research and products, which provided infrastructure support as well as donated study pills and packaging for COSMOS. They also received support from Pfizer Consumer Healthcare (now Haleon), which similarly supplied study pills and packaging during the trial. In addition, Sesso disclosed investigator-initiated grants from Haleon and Pure Encapsulations, along with honoraria and/or travel support for lectures from the Council for Responsible Nutrition, BASF, and the National Institutes of Health during the study period. No other study authors reported any conflicts of interest.
The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) is funded primarily through an investigator-initiated grant from Mars Edge, which provided infrastructure support and donated study pills and packaging. Additional support came from Pfizer Consumer Healthcare (now Haleon) through partial provision of study materials. The study also receives partial funding from National Institutes of Health grants AG050657, AG071611, EY025623, and HL157665, as well as an investigator-initiated grant from Haleon. Mars Edge and Haleon had no involvement in the study design or conduct, data collection or analysis, or the preparation and review of the manuscript. Separately, Bernhard Haring reported receiving lecture fees from Pfizer, Bristol Myers Squibb, Inari, Daiichi Sankyo, and Boehringer Ingelheim, all unrelated to this research.
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