Elevated Parathyroid Hormone, But Not Vitamin D Deficiency, Is Associated With Increased Risk of Heart Failure in Older Men With and Without Cardiovascular Disease

During the last two decades, the potential impact of vitamin D on the risk of cardiovascular disease (CVD) has been rigorously studied. Data regarding the effect of vitamin D on CVD risk are puzzling: observational data indicate an inverse nonlinear association between vitamin D status and CVD events, with the highest CVD risk at severe vitamin D deficiency; however, preclinical data and randomized controlled trials (RCTs) show several beneficial effects of vitamin D on the surrogate parameters of vascular and cardiac function. By contrast, Mendelian randomization studies and large RCTs in the general population and in patients with chronic kidney disease, a high-risk group for CVD events, largely report no significant beneficial effect of vitamin D treatment on CVD events. In patients with rickets and osteomalacia, cardiovascular complications are infrequently reported, except for an increased risk of heart failure. In conclusion, there is no strong evidence for beneficial vitamin D effects on CVD risk, either in the general population or in high-risk groups. Whether some subgroups such as individuals with severe vitamin D deficiency or a combination of low vitamin D status with specific gene variants and/or certain nutrition/lifestyle factors would benefit from vitamin D (metabolite) administration, remains to be studied.

Download Full-text

Is there any difference between Vitamin D deficiency among heart failure and Non-heart failure elderly with cardiovascular disease?

Pharmaceutical and Biomedical Research ◽

10.18869/acadpub.pbr.2.1.36 ◽

2016 ◽

Vol 2 (1) ◽

pp. 36-43

Author(s):

Zohreh Taraghi ◽

Ehteram sadat Ilali ◽

Tahereh Yaghoobi ◽

Soheil Azizi ◽

◽

...

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Vitamin D ◽

Vitamin D Deficiency

Download Full-text

Vitamin D deficiency is associated with increased risk of postural hypotension in older men: a cross-sectional analysis from The British Regional Heart Study

British Journal of General Practice ◽

10.3399/bjgp20x711209 ◽

2020 ◽

Vol 70 (suppl 1) ◽

pp. bjgp20X711209

Author(s):

Artaza Gilani ◽

Sheena Ramsay ◽

Paul Welsh ◽

Olia Papacosta ◽

Lucy Lennon ◽

...

Keyword(s):

Blood Pressure ◽

Vitamin D ◽

Parathyroid Hormone ◽

Vitamin D Deficiency ◽

Postural Hypotension ◽

Community Dwelling ◽

Cross Sectional ◽

Cross Sectional Analysis ◽

Increased Risk ◽

Sectional Analysis

BackgroundThere is growing interest in the role of vitamin D in extra-skeletal health, including postural hypotension. Postural hypotension is found in 1 in 5 community-dwelling adults aged 60 years and above. It increases risk of falls, fractures, cardiovascular disease and all-cause mortality. Better understanding of the aetiology of postural hypotension may help yield more effective treatment options than those that are currently available.AimThe aim of this study was to investigate the association between circulating vitamin D, parathyroid hormone and postural hypotension.MethodThis was a cross-sectional analysis of 3620 community-dwelling men living in the UK (mean age 68.6 years; standard deviation 5.5 years). Vitamin D status (nmol/L) was categorised as sufficient (≥50), insufficient (≥25 – <50), or deficient (<25). Parathyroid hormone levels were categorised by quintiles. Postural hypotension was defined by consensus criteria as a decrease in systolic blood pressure ≥20 mmHg and/or diastolic blood pressure ≥10 mmHg that occurred within three minutes of standing.ResultsCompared to sufficient levels of vitamin D, vitamin D deficiency increased risk of postural hypotension that specifically occurred within one minute of standing (OR 1.51, 95% CI = 1.06 to 2.15) in multinomial, multiple logistic regression. Neither vitamin D insufficiency, nor elevated parathyroid hormone, were associated with postural hypotension.ConclusionIn this study, vitamin D deficiency was associated with increased risk of postural hypotension. Further research may help clarify whether treating vitamin D deficiency can reduce the degree of postural hypotension, or if preventing the progression to vitamin D deficiency can reduce the incidence of postural hypotension.

Download Full-text

Circulating Vitamin D, Supplement Use, and Cardiovascular Disease Risk: The MrOS Sleep Study

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-4178 ◽

2014 ◽

Vol 99 (9) ◽

pp. 3256-3262 ◽

Cited By ~ 12

Author(s):

Archna Bajaj ◽

Katie L. Stone ◽

Katherine Peters ◽

Neeta Parimi ◽

Elizabeth Barrett-Connor ◽

...

Keyword(s):

Cardiovascular Disease ◽

Vitamin D ◽

Vitamin D Deficiency ◽

The United States ◽

Inverse Association ◽

Sleep Study ◽

Supplement Use ◽

Cerebrovascular Events ◽

Increased Risk ◽

25 Oh Vitamin D

Context: Evidence suggests an inverse association between circulating 25(OH) vitamin D and cardiovascular disease (CVD). Objective: To determine the association between serum 25(OH) vitamin D and risk for CVD events. Setting and Design: From March 2000 to April 2002, participants were recruited for the Osteoporotic Fractures in Men (MrOS) study. Between December 2003 and March 2005, members of the MrOS cohort were invited to participate in the MrOS Sleep Study. Participants were recruited from 6 clinical centers across the United States and followed for a mean of 5.9 years. Three-thousand-one-hundred-thirty-five men ages 65 and older were included from the MrOS cohort, of whom 116 were excluded for missing vitamin D or CVD data. Participants were divided into two groups based on serum 25(OH) vitamin D levels, <20 ng/mL and ≥20 ng/mL. Participants were followed for CVD endpoints including coronary heart disease (CHD) and cerebrovascular events. Age- and multivariable-adjusted hazard ratios were calculated and stratified by use of vitamin D containing supplements. Results: We observed no significant association between circulating 25(OH) vitamin D and risk of CVD event (HR, 0.91; 95% confidence interval (CI), 0.73–1.13) and CHD event (HR, 0.81; 95% CI, 0.61–1.07). For cerebrovascular events, men with vitamin D deficiency exhibited a higher risk (HR, 1.44; 95% CI, 1.00–2.08) using the minimally adjusted model and after excluding supplement users (HR, 1.70; 95% CI, 1.02–2.83). Conclusions: 25(OH) vitamin D was not associated with risk of CVD and CHD events. However, vitamin D deficiency may be associated with an increased risk of cerebrovascular events.

Download Full-text

The Impact of Obesity on the Association between Vitamin D Deficiency and Cardiovascular Disease

Nutrients ◽

10.3390/nu11102458 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2458 ◽

Cited By ~ 4

Author(s):

Paschou ◽

Kosmopoulos ◽

Nikas ◽

Spartalis ◽

Kassi ◽

...

Keyword(s):

Cardiovascular Disease ◽

Vitamin D ◽

General Population ◽

Vitamin D Deficiency ◽

Strong Association ◽

Vitamin D Supplementation ◽

Obese Adults ◽

Increased Risk ◽

High Prevalence ◽

The Impact

The aim of this article is to review the literature regarding the relationship between vitamin D deficiency and cardiovascular disease (CVD) and its modification in the presence of obesity. Despite the strong association between vitamin D status and cardiovascular outcomes, vitamin D supplementation trials in the general population have failed to decrease the incidence of cardiovascular events and mortality. A comprehensive study of the published literature and a comparison with experimental data lead to the conclusion that obesity, due to its high prevalence and strong association with both vitamin D deficiency and CVD, may act as a critical confounder, which is responsible for the different results on this association. Adoption of a vitamin D preventive supplementation strategy for CVD is unlikely to yield any benefit to the general population. However, it might be particularly useful in obese adults with increased risk for CVD.

Download Full-text

Insights into the Association of Vitamin D Deficiency with Parathyroid Hormone Levels with Relevance to Renal Function and Insulin Resistance

Current Nutrition & Food Science ◽

10.2174/1573401313666170920145038 ◽

2019 ◽

Vol 15 (2) ◽

pp. 196-200 ◽

Cited By ~ 1

Author(s):

Iyyapu K. Mohan ◽

Siraj A. Khan ◽

Rachel Jacob ◽

Kompella S.S.S. Baba ◽

Tajamul Hussain ◽

...

Keyword(s):

Insulin Resistance ◽

Vitamin D ◽

Renal Function ◽

Parathyroid Hormone ◽

Serum Creatinine ◽

Vitamin D Deficiency ◽

Plasma Vitamin ◽

Inverse Association ◽

Hormone Levels ◽

Increased Risk

Background: In majority of the studies inverse association between vitamin D and parathyroid hormone levels is documented. Objective: The rationale of the current study was to investigate whether this inverse association is agedependent and whether it has any role in modulating renal function and insulin resistance. Methods: To test this hypothesis, we have carried out a hospital based study enrolling 848 subjects (558 men and 290 women) with the mean age of 50.9 ± 15.9 y. Chemiluminometric competitive immune assays were performed using commercial kits to determine 25-OH vitamin D and Parathyroid Hormone (PTH) levels. Fasting glucose levels and serum creatinine were used to evaluate diabetes and renal function. Results: Vitamin D deficiency was predominant irrespective of age group (p = 0.21) and gender (p = 0.12). An inverse association between vitamin D and PTH was observed (r = -0.24) in middle age subjects (p = 0.02). The data segregation based on plasma vitamin D levels which were <20 ng/ml, 20.1- 30 ng/ml and >30 ng/ml confirmed the inverse association between vitamin D and PTH levels (ptrend: 0.007). Subjects with low plasma vitamin D and increased PTH exhibited elevated blood urea, serum creatinine and blood glucose. Subjects with 25-OHD deficiency showed a 3.03-folds (95% CI: 2.26- 4.07) and 2.09-fold (1.41-3.10) increased risk for diabetes and renal disease, respectively. Conclusion: Based on the results of the present study, it is suggested that those with vitamin D deficiency need to be evaluated for possible presence of renal dysfunction, diabetes/insulin resistance in addition to assessing their PTH status.

Download Full-text