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The search for dietary supplements to reduce the risk for atrial fibrillation (AF) has a long history. Observational data have often shown an association with vitamins and lower cardiovascular events. However, these studies are troubled by residual confounding, particularly because people with good behaviors likely have other positive behaviors that an observational study cannot fully capture. To learn about possible benefits of the popular supplements fish oil and vitamin D, researchers conducted the VITAL Rhythm trial (NCT02178410), which was ancillary to the randomized, controlled VITAL study (NEJM JW Cardiol Jan 2019 and N Engl J Med 2019; 380:33).
In VITAL, 25,119 older individuals (mean age, 67; 51% women) without heart disease receive…