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Serum Vitamin D and Risk of Cardiovascular Mortality

7/17/2018 2:17:31 PM
Vitamin D is thought to be required for cardiovascular health, with mechanistic studies showing that vitamin D may affect endothelial function, fibrosis, and inflammation. Meta-analyses of observational studies have determined that serum vitamin D (25OHD) is inversely related to cardiovascular mortality in healthy individuals, but studies among patients with cardiovascular disease have produced inconsistent results. To better understand the relationship between serum vitamin D and mortality in patients with stable cardiovascular disease, researchers in Norway evaluated prospective data from 4114 individuals with stable angina pectoris.
Patients were recruited from 2 university hospitals in Norway between 1999 and 2004, at which point baseline serum 25OHD levels were measured. Plasma 25OHD ranged from 8.4 to 197 nmol/L (3.2 – 78.8 ng/mL). Patients were followed until death or 2013, with a 12-year mean duration of follow-up. Of the 4114 individuals followed, there were 895 (21.8%) deaths from all causes and 407 (9.9%) deaths from cardiovascular disease.
Patients in the upper 3 quartiles of 25OHD concentration were at significantly lower risk of all-cause and cardiovascular mortality when compared with those in the lowest quartile. Compared with the lowest quartile of 25OHD concentration, hazards ratios (HRs) for the upper 3 quartiles for all-cause mortality were 0.64, 0.56, and 0.56, and HRs for cardiovascular mortality were 0.70, 0.60. and 0.57.
The potential thresholds to discriminate between low-risk and high-risk groups were identified as 42.5 nmol/L for all-cause mortality and 40.9 nmol/L (16.4 ng/mL) (for cardiovascular mortality. Patients with 25OHD >100 nmol/L (40 ng/mL) were also at an increased risk for all-cause mortality. Vitamin D sufficiency for skeletal health is currently defined as 25OHD ≥50 nmol/L (20 ng/mL), and the findings from this study suggest that a similar threshold applies to cardiovascular risk.
Degerud E, Nygård O, de Vogel S et al. Plasma 25-Hydroxyvitamin D and Mortality in Patients With Suspected Stable Angina Pectoris. J Clin Endocrinol Metab. 2018; 103: 1161-1170.