I recently saw a television ad urging me to take a new, one-a-day vitamin pill to keep my heart healthy. It?s very unlikely that I will take this pill, or any other multivitamin for that matter. In my lectures on vitamins to medical students, I proudly stated that I had never taken a vitamin pill, until I overheard a student in the front row whisper to his neighbor, ?No wonder he looks so bad.?

The advertised vitamin pill, called One-A-Day Cholesterol Plus, is said to protect the heart because it contains policosanol and folic acid, as well as all the other needed vitamins and minerals. Folic acid is a component of all multivitamin pills, but no others contain policosanol, a substance isolated from sugar cane wax and developed in Cuba as a cholesterol-lowering dietary supplement.

A number of controlled clinical trials found that 10-mg doses of policosanol, the amount contained in this new vitamin pill, significantly lowered cholesterol and raised HDL cholesterol in people with normal or elevated cholesterol levels.

Little is known about how policosanol produces these effects. Its use was approved in Cuba in 1991 and subsequently in more than 25 other countries, mostly in South America and the Caribbean. No approval is needed in the U.S. because it is a dietary supplement rather than a drug. One possible concern is the lack of studies to determine whether dangerous interactions may occur between policosanol and commonly used medications.

One-A-Day Cholesterol Plus is marketed by Bayer Health Care. Ads on the Internet state that it does not lower cholesterol and is aimed at people whose cholesterol is in the normal range. The product was launched nationwide in April 2005 and is on the shelves of our local supermarket.