Serum 25-Hydroxyvitamin D Concentration and Mortality from Heart Failure and Cardiovascular Disease, and Premature Mortality from All-Cause in United States Adults

Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA, USA.
The American journal of cardiology (Impact Factor: 3.28). 06/2012; 110(6):834-9. DOI: 10.1016/j.amjcard.2012.05.013
Source: PubMed


We aimed to examine associations between serum 25-hydroxyvitamin D (25[OH]D) concentration and mortality from heart failure (HF) and cardiovascular disease (CVD) and premature death from all causes using data from the Third National Health and Nutrition Examination Survey, which included 13,131 participants (6,130 men, 7,001 women) ≥35 years old at baseline (1988 to 1994) and followed through December 2000. Premature death was defined all-cause death at <75 years of age. Results indicated that during an average 8-year follow-up, there were 3,266 deaths (24.9%) including 101 deaths from HF, 1,451 from CVD, and 1,066 premature all-cause deaths. Among HF deaths, 37% of decedents had serum 25(OH)D levels <20 ng/ml, whereas only 26% of those with non-HF deaths had such levels (p <0.001). Multivariate-adjusted Cox model indicated that subjects with serum 25(OH)D levels <20 ng/ml had 2.06 times higher risk (95% confidence interval 1.01 to 4.25) of HF death than those with serum 25(OH)D levels ≥30 ng/ml (p <0.001). In addition, hazard ratios (95% confidence intervals) for premature death from all causes were 1.40 (1.17 to 1.68) in subjects with serum 25(OH)D levels <20 ng/ml and 1.11 (0.93 to 1.33) in those with serum 25(OH)D levels of 20 to 29 ng/ml compared to those with serum 25(OH)D levels ≥30 ng/ml (p <0.001, test for trend). In conclusion, adults with inadequate serum 25(OH)D levels have significantly higher risk of death from HF and all CVDs and all-cause premature death.

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    • "Initial clinical trials to test whether supplementation with vitamin D is beneficial in patients with CVD have shown benefit [70]. Both low circulating 25(OH)D levels and high plasma renin activity are associated independently with poor prognosis in patients with chronic heart failure [75, 76]. A recent open-label, blinded, endpoint, phase II trial in cardiac heart failure patients showed that vitamin D3 supplementation lowers plasma renin activity using 2,000 IU daily [77]. "
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