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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #204169
Title: Vitamin D Deficiency and the Risk of Cardiovascular Disease

Author
item WANG, THOMAS - FRAMINGHAM HEART STUDY
item PENCINA, MICHAEL - FRAMINGHAM HEART STUDY
item Booth, Sarah
item Jacques, Paul
item INGELSSON, ERIK - FRAMINGHAM HEART STUDY
item LANIER, KATHERINE - FRAMINGHAM HEART STUDY
item BENJAMIN, EMELIA - FRAMINGHAM HEART STUDY
item D'AGOSTINO, RALPH - FRAMINGHAM HEART STUDY
item WOLF, MYLES - MASS GENERAL/HARVARD MED
item VASAN, RAMACHANDRAN - FRAMINGHAM HEART STUDY

Submitted to: Circulation
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 11/2/2007
Publication Date: 2/1/2008
Citation: Wang, T., Pencina, M.J., Booth, S.L., Jacques, P., Ingelsson, E., Lanier, K., Benjamin, E.J., D'Agostino, R.B., Wolf, M., Vasan, R.S. 2008. Vitamin D Deficiency and the Risk of Cardiovascular Disease. Circulation. 117:503-511.

Interpretive Summary: Vitamin D receptors are found in many tissues, including heart muscle cells. A growing body of evidence suggests that vitamin D deficiency may adversely affect the cardiovascular system, but few prospective data exist. This study examined the relation of vitamin D status, assessed using circulating levels of vitamin D to the number of first cardiovascular events in 1739 Framingham Heart Study participants (mean age 59 years, 55% women). Vitamin D deficiency was defined as either moderate or severe based on pre-specified ranges the vitamin D blood levels. The results showed that 28% of the participants had vitamin D deficiency. During a mean follow-up of 5.4 years, 120 individuals developed a first cardiovascular event. Overall, vitamin D deficiency was associated with an increased risk for new cardiovascular events. Severe vitamin D deficiency was associated with greater risk for cardiovascular events compared to those with moderate vitamin D deficiency. The excess risk was particularly prominent in hypertensive individuals. The findings show that vitamin D is associated with increased risk of developing cardiovascular disease, which may have public health implications, given how common vitamin D deficiency is, the contribution of lifestyle to vitamin D status, and the ease and low cost of repletion.

Technical Abstract: Vitamin D receptors have a broad tissue distribution that includes vascular smooth muscle, endothelium, and cardiomyocytes. A growing body of evidence suggests that vitamin D deficiency may adversely affect the cardiovascular system, but few prospective data exist. This study examined the relation of vitamin D status, assessed using 25-dihydroxyvitamin-D (25-OH D) levels, to the incidence of first cardiovascular events in 1739 Framingham Heart Study participants (mean age 59 years, 55% women). Pre-specified thresholds were used for moderate (10 to <15 ng/ml) and severe (<10 ng/ml) vitamin D deficiency. Multivariable Cox regression models were adjusted for conventional risk factors and renal function. The results showed that the prevalence of vitamin D deficiency (25-OH D <15 ng/ml) was 28%. During a mean follow-up of 5.4 years, 120 individuals developed a first cardiovascular event. Overall, vitamin D deficiency was associated with a multivariable-adjusted hazards ratio of 1.62 (95% confidence interval {CI}, 1.11-2.36; p=0.001) for incident cardiovascular events. Moderate and severe vitamin D deficiency were associated with multivariable-adjusted hazards ratios of 1.53 (95% CI, 1.00-2.36) and 1.80 (95% CI, 1.05-3.08), respectively. The excess risk was particularly prominent in hypertensive individuals, who had multivariable-adjusted hazards ratios of 1.93 (95% CI, 1.09-3.42) for moderate and 2.51 (95% CI, 1.30-4.82) for severe vitamin D deficiency. The findings show that vitamin D is associated with increased risk of developing cardiovascular disease, which may have public health implications, given the high prevalence of vitamin D deficiency, the contribution of lifestyle to vitamin D status, and the ease and low cost of repletion.