Glucosamine/chondroitin use significantly associated with lower overall, CVD mortality
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Regular intake of glucosamine/chondroitin was associated with lower all-cause and CVD mortality among adults aged older than 40 years in the United States, data from a cohort study showed.
“Previous studies had looked at one state — Washington — or Britain,” Dana E. King, MD, MS, a professor and chair of the department of family medicine at West Virginia University (WVU) Medicine, told Healio Primary Care. “This is the first national study in the United States to confirm the association between intake of glucosamine/chondroitin and mortality.”
King and Jun Xiang, MS, MA, a research assistant in the department of family medicine at WVU Medicine, used combined data from 16,686 adults who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2010, and they merged baseline survey results with the 2015 Public-use Linked Mortality File, which provided mortality follow-up data from the NHANES participants. Participants were followed for a median of 107 months. According to the researchers, 658 of the study population used glucosamine/chondroitin.
“The average dose we could calculate was between 500 mg and 1,000 mg of glucosamine daily, which is a little below the recommended dose of 1,500 mg glucosamine daily (with 1,200 mg chondroitin daily),” King said. “However, the amount and consistency of supplement intake was not tracked for adherence throughout the follow-up period.”
As a result, King and Xiang said they chose “only people who had been taking the supplement for a year or more [and] to select consistent long-term users.”
The results, published in the Journal of the American Board of Family Medicine, showed there were 3,366 deaths, of which 674 were due to CVD. Respondents taking glucosamine/chondroitin were less likely to have CVD mortality (HR = 0.51; 95% CI, 0.28-0.92). After controlling for age, glucosamine/chondroitin use was associated with a 39% reduction in all-cause mortality (HR = 0.61; 95% CI, 0.49-0.77) and a 65% reduction in CVD mortality (HR = 0.35; 95% CI, 0.2-0.61). These associations remained after the researchers adjusted their analysis for numerous factors — including “age, race, sex, smoking, educational status and exercise,” King said (all-cause mortality HR = 0.73; 95% CI, 0.57-0.93; CVD mortality HR = 0.42; 95% CI, 0.23-0.75).
King said the large number of individual vitamins, multivitamins and other supplements that the American public consumed during the study period made it impossible “to account for all the possibilities of interaction. However, individual vitamins, multivitamins and other supplements have not been associated with lower overall mortality, so they should not have interfered with this analysis.”
Although the findings are consistent with those from other studies, he encouraged a long-term prospective randomized study to validate them.
Perspective
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Craig Beavers, PharmD, FACC, FAHA, FCCP
This epidemiology-based, hypothesis-generating study confirms results from previous studies with similar types of methodology. But correlation is not always necessarily causation.
We need studies to determine if King and Xiang’s conclusion is real. Biologically, the benefit they observed could be due to glucosamine/chondroitin helping to reduce anti-inflammatory activities through C reactive protein. Alternatively, the benefit could be that these supplements allow patients to exercise more and whether that is what staves off the CVD.
Therefore, we need to have proper prospective randomized trials to truly address the benefit and also figure out the minimum and maximum dose that is required to see health benefits. How long would they need to take these supplements to see those benefits?
Until these types of studies are done, I'm not going to tell patients to start taking glucosamine/chondroitin to prevent CVD.
Adjunct assistant professor, University of Kentucky College of Pharmacy
Cardiovascular Clinical Pharmacist, UK HealthCare, Lexington, Ky.
Director of cardiovascular services, Baptist Health Paducah, Ky.
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