Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Selenium is an essential trace mineral that plays a critical role in antioxidant defense systems, primarily through its incorporation into selenoproteins such as glutathione peroxidase. These enzymes help protect cells from oxidative damage, which is implicated in the development and progression of cardiovascular disease (CVD). Historically, selenium deficiency has been associated with Keshan disease, a cardiomyopathy prevalent in regions with low selenium soil content. This observation led to interest in selenium’s potential cardioprotective properties.

Several observational studies have found that low selenium levels are associated with an increased risk of CVD, including coronary artery disease and heart failure. Proposed mechanisms include reduced antioxidant capacity and increased inflammation. However, randomized controlled trials (RCTs) and meta-analyses of selenium supplementation in populations with adequate selenium intake have not consistently shown a benefit in reducing cardiovascular events or mortality. For example, large trials such as the SELECT trial did not find significant reductions in CVD outcomes with selenium supplementation. Additionally, excessive selenium intake can have adverse effects, including an increased risk of type 2 diabetes.

In summary, while there is a scientific rationale for selenium’s role in cardiovascular health and some supportive observational data, robust clinical evidence from RCTs for benefit in supplementation—especially in selenium-replete populations—is lacking. Therefore, selenium supplementation is not broadly recommended for the prevention or treatment of cardiovascular disease except in cases of documented deficiency.

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