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Taking multivitamins does not reduce the risk for heart disease, a review of studies has found.

The analysis, in Circulation: Cardiovascular Quality and Outcomes, pooled data from 18 studies with more than two million participants. All took supplements that included at least three vitamin and mineral ingredients and no herbs, hormones or drugs.

Eleven of the studies were done in the United States, four in Europe and three in Japan. Follow-up varied from five to 19 years. Two were randomized controlled trials, and the rest prospective observational studies.

The pooled data showed no association between multivitamins and the risk for cardiovascular disease, coronary heart disease or stroke incidence or mortality. In observational studies, there was a small association with coronary heart disease incidence, but none in randomized controlled trials.

“Multivitamins rarely cause harm, but they’re not completely safe either,” said the lead author, Dr. Joonseok Kim, an assistant professor of medicine at the University of Alabama at Birmingham. “Some ingredients can interact with other medicines and cause side effects.