Multivitamins showed no broad effect on blood pressure in older adults, but they offered small, meaningful benefits for those with poorer diets or normal baseline BP.
New findings from Mass General Brigham investigators indicate that taking a daily multivitamin over a long period may help lower the risk of developing hypertension and may also reduce blood pressure (BP) in certain groups of older adults.
Researchers conducted a secondary review of data from the COcoa Supplement and Multivitamin Outcomes Study (COSMOS) and determined that, for the overall study population, daily multivitamin use did not differ from a placebo in its impact on hypertension risk or blood pressure. Even so, the analysis revealed modest but meaningful benefits among participants who had poorer diet quality and among those who started the study with normal BP. The study results appear 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.
Study Design and Participant Groups
COSMOS is a randomized and placebo-controlled clinical trial designed to explore how cocoa extract and multivitamin supplements influence health in older adults in the U.S. For this analysis, the investigators focused on 8,905 participants who did not have hypertension at the start of the study and who were assigned to take either Centrum Silver or a placebo each day for a median period of 3.4 years.
The team also assessed changes in blood pressure over a two year span in two additional groups that included 529 participants with clinic-based measurements and 994 participants who recorded their measurements at home.
Overall, the investigators found no differences in self-reported incident hypertension between the multivitamin and placebo groups. Multivitamins lowered risk of hypertension in participants with comparatively lower diet quality, as measured by Alternative Healthy Eating Index (AHEI) and Alternate Mediterranean Diet (aMED) scores. In addition, participants with normal BP at baseline taking a daily multivitamin experienced small, significant reductions in BP measurements over two years.
The authors propose that further research is required to examine the effects of a daily multivitamin in younger and middle-aged adults, and across different populations based on nutritional status.
Reference: “Long-Term Effect of Multivitamin Supplementation on Incident Self-Reported Hypertension and Blood Pressure Changes in the COSMOS Trial” by Rikuta Hamaya, Sidong Li, Jessica Lau, Susanne Rautiainen, Bernhard Haring, Simin Liu, Aladdin H Shadyab, Lisa Warsinger Martin, Sylvia Wassertheil-Smoller, Pamela M Rist, JoAnn E Manson, Howard D Sesso and COSMOS Research Group, 20 November 2025, American Journal of Hypertension.
DOI: 10.1093/ajh/hpaf224
Disclosures: Sesso and Manson received investigator-initiated grants from Mars Edge, a segment of Mars Incorporated dedicated to nutrition research and products, for infrastructure support and donation of COSMOS study pills and packaging, and Pfizer Consumer Healthcare (now Haleon) for donation of COSMOS study pills and packaging during the conduct of the study. Sesso additionally reported receiving investigator-initiated grants from Haleon and Pure Encapsulations, and honoraria and/or travel 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.
Funding: 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 included infrastructure support and the donation of study pills and packaging. Pfizer Consumer Healthcare (now Haleon) provided support through the partial provision of study pills and packaging. COSMOS is also supported in part by grants AG050657, AG071611, EY025623, and HL157665 from the National Institutes of Health, Bethesda, MD, and an investigator-initiated grant from Haleon. Neither company had a role in the trial design or conduct, data collection, data analysis, or manuscript preparation or review. Bernhard Haring reports lecture fees from Pfizer, Bristol Myers Squibb, Inari, Daiichi Sankyo and Boehringer Ingelheim, all unrelated to this study.
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