scholarly journals Prevalence and Outcomes Associated with Vitamin D Deficiency among Indexed Hospitalizations with Cardiovascular Disease and Cerebrovascular Disorder—A Nationwide Study

Medicines ◽  
2020 ◽  
Vol 7 (11) ◽  
pp. 72
Author(s):  
Urvish Patel ◽  
Salma Yousuf ◽  
Komal Lakhani ◽  
Payu Raval ◽  
Nirmaljot Kaur ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
Regression Analysis ◽  
Vitamin D Deficiency ◽  
Admission Diagnosis ◽  
Cerebrovascular Disorder ◽  
Vascular Events ◽  
Mixed Effect ◽  
Discharge Disposition ◽  
Acute Mi

Background: According to past studies, recovery and survival following severe vascular events such as acute myocardial infarction and stroke are negatively impacted by vitamin D deficiency. However, the national estimate on disability-related burden is unclear. We intend to evaluate the prevalence and outcomes of vitamin D deficiency (VDD) among patients with cardiovascular disease (CVD) and cerebrovascular disorder (CeVD). Methods: We performed a cross-sectional study on the Nationwide Inpatient Sample data (2016–2017) of adult (≥18 years) hospitalizations. We identified patients with a secondary diagnosis of VDD and a primary diagnosis of CVD and CeVD using the 9th revision of the International Classification of Diseases, clinical modification code (ICD-10-CM) codes. A univariate and mixed-effect multivariable survey logistic regression analysis was performed to evaluate the prevalence, disability, and discharge disposition of patients with CVD and CeVD in the presence of VDD. Results: Among 58,259,589 USA hospitalizations, 3.44%, 2.15%, 0.06%, 1.28%, 11.49%, 1.71%, 0.38%, 0.23%, and 0.08% had primary admission of IHD, acute MI, angina, AFib, CHF, AIS, TIA, ICeH, and SAH, respectively and 1.82% had VDD. The prevalence of hospitalizations due to CHF (14.66% vs. 11.43%), AIS (1.87% vs. 1.71%), and TIA (0.4% vs. 0.38%) was higher among VDD patients as compared with non-VDD patients (p < 0.0001). In a regression analysis, as compare with non-VDD patients, the VDD patients were associated with higher odds of discharge to non-home facilities with an admission diagnosis of CHF (aOR 1.08, 95% CI 1.07–1.09), IHD (aOR 1.24, 95% CI 1.21–1.28), acute MI (aOR 1.23, 95% CI 1.19–1.28), AFib (aOR 1.21, 95% CI 1.16–1.27), and TIA (aOR 1.19, 95% CI 1.11–1.28). VDD was associated with higher odds of severe or extreme disability among patients hospitalized with AIS (aOR 1.1, 95% CI 1.06–1.14), ICeH (aOR 1.22, 95% CI 1.08–1.38), TIA (aOR 1.36, 95% CI 1.25–1.47), IHD (aOR 1.37, 95% CI 1.33–1.41), acute MI (aOR 1.44, 95% CI 1.38–1.49), AFib (aOR 1.10, 95% CI 1.06–1.15), and CHF (aOR 1.03, 95% CI 1.02–1.05) as compared with non-VDD. Conclusions: CVD and CeVD in the presence of VDD increase the disability and discharge to non-home facilities among USA hospitalizations. Future studies should be planned to evaluate the effect of VDD replacement for improving outcomes.

Abstract 13697: Prevalence and Disability Associated With Vitamin D Deficiency Amongst Patients With Cardiovascular and Cerebrovascular Disorders

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Nirmaljot Kaur ◽  
Angelina Yogarajah ◽  
Chika Nwodika ◽  
Rashmi Subhedar ◽  
Payu Raval ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Cerebrovascular Disorders ◽  
Primary Diagnosis ◽  
Loss Of Function ◽  
Vascular Events ◽  
Chi Square ◽  
Icd 10 ◽  
Chi Square Test ◽  
Acute Mi

Introduction: Previous studies had provided evidence that vitamin D deficiency is a strong negative predictor for survival and recovery after severe vascular events but national estimate on disability related burden is not clear. Hypothesis: We evaluate the prevalence of vitamin D deficiency (VDD) amongst patients with cardiovascular disease (CVD) and cerebrovascular disorders (CeVD) and to find out whether or not CVD and CeVD in the presence of VDD increases the disability. Methods: We performed a retrospective analysis of the Nationwide Inpatient Sample data (years 2016-2017) in adults (≥18 years) hospitalizations. We identified patients with secondary diagnosis of VDD and primary diagnosis of CVD (AFib, CHF, IHD, acute MI, and angina) and CeVD (AIS, TIA, ICeH and SAH) using ICD-10-CM codes. We performed a chi-square test and multivariable survey logistic regression to analyze disability of patients with CVD and CeVD in presence of VDD. Disability/loss of function was investigated by APRDRGs severity using 3M Health Information Systems software. (Score 1-4 indicates minor to extreme loss of function) Results: Among 58,259,589 US hospitalizations, 3.44%, 2.15%, 0.06%, 1.28%, 11.49%, 1.71%, 0.38%, 0.23% and 0.08% had primary admission of IHD, acute MI, angina, AFib, CHF, AIS, TIA, ICeH and SAH, respectively and 1.82% had VDD. Prevalence of hospitalizations due to CHF (14.66% vs 11.43%), AIS (1.87% vs 1.71%) and TIA (0.4% vs 0.38%) was higher; and IHD (2.62% vs 3.45%), acute MI (1.58% vs 2.16), angina (0.05% vs 0.06%), AFib (1.14% vs 1.28%), ICeH (0.17% vs 0.23%) and SAH (0.05% vs 0.08%) was lower among VDD patients in compare to non-VDD. (p<0.0001) In regression analysis, VDD was associated with higher odds of severe or extreme disability amongst patients hospitalized with AIS (OR:1.1; 95%CI:1.06-1.14), ICeH (1.22; 1.08-1.39), TIA (1.36; 1.25-1.47), IHD (1.37; 1.33-1.41), acute MI (1.44; 1.38-1.49), Afib (1.10; 1.06-1.15), and CHF (1.03; 1.02-1.05) in comparison to without VDD. Conclusions: CVD and CeVD in presence of VDD increase the disability amongst US hospitalizations. Future studies should be planned to evaluate the discharge outcomes as well as the effect of identification and in-hospital management of VDD on improvement of the outcomes.

scholarly journals Vitamin D and Cardiovascular Disease: An Updated Narrative Review

2021 ◽  
Vol 22 (6) ◽  
pp. 2896
Author(s):  
Armin Zittermann ◽  
Christian Trummer ◽  
Verena Theiler-Schwetz ◽  
Elisabeth Lerchbaum ◽  
Winfried März ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
High Risk ◽  
General Population ◽  
Vitamin D Deficiency ◽  
Specific Gene ◽  
Vitamin D Status ◽  
Cvd Risk ◽  
Severe Vitamin ◽  
Increased Risk

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.

scholarly journals Relation of serum 25(OH) D with variables of thyroid and lipid profile in perimenopausal women

2017 ◽  
Vol 6 (3) ◽  
pp. 1087
Author(s):  
Poonam Rani ◽  
Seema Gupta ◽  
Gaurav Gupta
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
Lipid Profile ◽  
Vitamin D Deficiency ◽  
Serum Levels ◽  
The Body ◽  
P Value ◽  
Thyroid Disorder ◽  
Vitamin D Levels ◽  
Perimenopausal Women

Background: Deficiency of vitamin D is quite prevalent among elderly population or postmenopausal women worldwide and may affect various function of the body. The status of its deficiency with their relation with other variables are not well explored in perimenopausal women.Methods: 100 perimenopausal women from the department of obstetrics and gynaecology were selected without having known risk of thyroid disorder and cardiovascular disease. The age group criteria for these women were 40 to 50 years. Thyroid profile including TSH, T3, and T4 were estimated by using enzyme linked immunesorbent assay. Serum levels of 25(OH) D3 was estimated by using spectrophotometric method. Lipid profile including TC, TG and HDL-C were estimated CHOD-POD method, GPO-PAP method, and CHOD-POD/Phosphotungustate method. LDL-C was calculated by friedewald formula.Results: There 58 women were presented with insufficient amount of vitamin D. They were characterised with increased BMI, elevated thyrotropin alongwith lower concentrations of T3 and T4. Increased levels of TC, TG and LDL-cholesterol alongwith lower concentration of HDL-C were also observed in women with vitamin d deficiency. Women having vitamin D deficiency were presented with overweight (OR-18.0, p-value=<0.001) and dyslipidemia (OR-12.13, p-value≤0.001). Vitamin D was negatively correlated with variable i.e. BMI, TSH, TC, TG and LDL-C. This negative association was significant (<0.001) while HDL-C and T4 were positively correlated with vitamin D levels in this study population.Conclusions: Vitamin D deficiency frequently occurs in middle aged perimenopausal women. Negative correlation of it with BMI, TSH and lipid variables may suggest the development of cardiovascular disease and hypothyroidism in coming years. Vitamin D supplements or vitamin D containing diet and regular exposure to sun is highly recommended to perimenopausal women.

scholarly journals Vitamin D as A Protector of Arterial Health: Potential Role in Peripheral Arterial Disease Formation

2019 ◽  
Vol 20 (19) ◽  
pp. 4907 ◽  
Author(s):  
Smriti Murali Krishna
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
Peripheral Arterial Disease ◽  
Vitamin D Deficiency ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Experimental Studies ◽  
Arterial Disease ◽  
Current Evidence ◽  
Peripheral Arterial

Atherosclerotic occlusive diseases and aneurysms that affect large and medium-sized arteries outside the cardiac and cerebral circulation are collectively known as peripheral arterial disease (PAD). With a rise in the rate of aging population worldwide, the number of people diagnosed with PAD is rapidly increasing. The micronutrient vitamin D is an important steroid hormone that acts on many crucial cellular mechanisms. Experimental studies suggest that optimal levels of vitamin D have beneficial effects on the heart and blood vessels; however, high vitamin D concentrations have been implicated in promoting vascular calcification and arterial stiffness. Observations from various clinical studies shows that deficiency of vitamin D has been associated with a greater risk of PAD. Epidemiological studies have often reported an inverse relation between circulating vitamin D status measured in terms of 25-hydroxivitamin D [25(OH)D] levels and increased cardiovascular disease risk; however, randomized controlled trials did not show a consistent positive effect of vitamin D supplementation on cardiovascular disease risk or events. Even though PAD shares all the major risk factors with cardiovascular diseases, the effect of vitamin D deficiency in PAD is not clear. Current evidence suggests a strong role of vitamin D in promoting genomic and epigenomic changes. This review summarises the current literature that supports the notion that vitamin D deficiency may promote PAD formation. A better understanding of underlying pathological mechanisms will open up new therapeutic possibilities which is the main unmet need in PAD management. Furthermore, epigenetic evidence shows that a more holistic approach towards PAD prevention that incorporates a healthy lifestyle, adequate exercise and optimal nutrition may be more effective in protecting the genome and maintaining a healthy vasculature.

scholarly journals Vitamin D and Atherosclerotic Cardiovascular Disease

2019 ◽  
Vol 104 (9) ◽  
pp. 4033-4050 ◽  
Author(s):  
Thomas F Hiemstra ◽  
Kenneth Lim ◽  
Ravi Thadhani ◽  
JoAnn E Manson
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
General Population ◽  
Vitamin D Deficiency ◽  
Randomized Trials ◽  
Cardiovascular Health ◽  
Vitamin D Supplementation ◽  
High Dose ◽  
Atherosclerotic Cardiovascular Disease ◽  
Vitamin D Levels

Abstract Context A large body of experimental and observational data has implicated vitamin D deficiency in the development of cardiovascular disease. However, evidence to support routine vitamin D supplementation to prevent or treat cardiovascular disease is lacking. Design and Results A comprehensive literature review was performed using PubMed and other literature search engines. Mounting epidemiological evidence and data from Mendelian randomization studies support a link between vitamin D deficiency and adverse cardiovascular health outcomes, but randomized trial evidence to support vitamin D supplementation is sparse. Current public health guidelines restrict vitamin D intake recommendations to the maintenance of bone health and prevention of fractures. Two recently published large trials (VITAL and ViDA) that assessed the role of moderate- to high-dose vitamin D supplementation as primary prevention for cardiovascular outcomes in the general population had null results, and previous randomized trials have also been generally negative. These findings from general population cohorts that are largely replete in vitamin D may not be applicable to chronic kidney disease (CKD) populations, in which the use of active (1α-hydroxylated) vitamin D compounds is prevalent, or to other high-risk populations. Additionally, recent trials in the CKD population, as well as trials using vitamin D analogs, have been limited. Conclusions Current randomized trials of vitamin D supplementation do not support benefits for cardiovascular health, but the evidence remains inconclusive. Additional randomized trials assessing larger numbers of participants with low baseline vitamin D levels, having longer follow-up periods, and testing higher vitamin D dosages are needed to guide clinical practice.

Vitamin D Deficiency and Its Implications on Cardiovascular Disease

2010 ◽  
Vol 4 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Nisha Aggarwal ◽  
Jared P. Reis ◽  
Erin D. Michos
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
Vitamin D Deficiency

scholarly journals Possible Health Implications and Low Vitamin D Status during Childhood and Adolescence: An Updated Mini Review

2010 ◽  
Vol 2010 ◽  
pp. 1-7 ◽  
Author(s):  
Dimitrios Papandreou ◽  
Pavlos Malindretos ◽  
Zacharoula Karabouta ◽  
Israel Rousso
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
Developing Countries ◽  
Life Span ◽  
Vitamin D Deficiency ◽  
Chronic Diseases ◽  
Adult Life ◽  
Childhood And Adolescence ◽  
Vitamin D Status ◽  
Calcium Insufficiency

Vitamin D deficiency is common in the developing countries and exists in both childhood and adult life. The great importance of Vitamin D is the moderation of calcium (Ca) and phosphorus (P) homeostasis as well as the absorption of Ca. While insufficiency of vitamin D is a significant contributing factor to risk of rickets in childhood, it is possible that a more marginal deficiency of vitamin D during life span contribute to osteoporosis as well as potentially to the development and various other chronic diseases such as cardiovascular disease, cancer and diabetes. This paper reviews the metabolism, epidemiology, and treatment of vitamin D and calcium insufficiency as well as its relation to various diseases during childhood and adolescence.

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