Is vitamin D deficiency a risk factor for all-cause mortality and rehospitalization in heart failure patients?: A systematic review and meta-analysis

Wang, Xiuming; Wang, Jun; Gao, Tingting; Sun, Hong‐Bo; Yang, Baisong

doi:10.1097/md.0000000000029507

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…204,205 Observational studies have frequently, although not always, 206 indicated an association between vitamin D deficiency and increased risk of CVD. [207][208][209][210][211][212] A study of 1739 Framingham Offspring Study participants found a graded increase in the risk of first cardiovascular events with greater degrees of vitamin D deficiency over 5.4 years of mean follow-up. 213 A meta-analysis of 25 prospective cohort studies of healthy individuals (with 10,099 cases of CVD) noted that while low vitamin D levels were correlated with an increased relative risk of CVD (RR 1.44, 95% CI 1.24-1.69), there was no significant relationship between vitamin D status and CVD incidence (RR 1.18, 95% CI 1-1.39).…”

Section: Vitamin Dmentioning

confidence: 99%

The interplay between bone and heart health as reflected in medication effects: A narrative review

Trost

Tesfaye

Harindhanavudhi

2023

Womens Health (Lond Engl)

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There is mounting evidence of an association between osteoporosis and cardiovascular disease that extends beyond shared risk factors for these conditions. In turn, the medications used to treat each of these conditions can have effects that impact the other organ system: medications used in heart disease have the potential to affect bone health, while osteoporosis medications may modify cardiovascular health. While data in this subject area are limited by the paucity of large randomized controlled trials with bone mineral density or fracture risk as primary outcomes, this review explores the data available that can provide some insight into these reciprocal effects of medications on bone and heart health. Data on bone health effects of the loop and thiazide diuretics, beta blockers, calcium channel blockers, statins, warfarin, sodium-glucose cotransporter 2 inhibitors, metformin, and medications impacting the renin–angiotensin–aldosterone system are examined; the cardiovascular effects of osteoporosis therapies and vitamin D are also discussed. Importantly, while most data in this realm are inconclusive, recognizing the parallels between cardiovascular and bone disorders and how this is reflected in medication effects might prompt the clinician to consider the indirect impact of drug regimens when making therapeutic choices for patients with osteoporosis and heart disease.

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Section: Vitamin Dmentioning

confidence: 99%

The interplay between bone and heart health as reflected in medication effects: A narrative review

Trost

Tesfaye

Harindhanavudhi

2023

Womens Health (Lond Engl)

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“…Wang et al published in 2022 a meta-analysis that found patients with low levels of 25-OHD had a nearly 35% higher risk of mortality compared to patients with normal or higher 25-OHD levels, suggesting that 25-OHD levels may be a significant predictor for mortality in HF patients. Furthermore, every 10 nmol/L decrease in 25-OHD levels was associated with a 10% increase in the risk of mortality [ 55 ]. Interestingly, contrary findings were discovered in another recent meta-analysis from 2022 that examined eight global observational studies with a total of 426.039 patients.…”

Section: Vitamin D and Heart Failurementioning

confidence: 99%

Is Hypovitaminosis D a Risk Factor for Heart Failure?

Hagău

Pușcaș

Togănel

et al. 2023

Life

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Background: Several studies in recent years have shown the association between vitamin D levels and heart failure. Vitamin D deficiency is related to increased cardiovascular morbidity and mortality, with a higher risk of developing heart failure. In this systematic review, we aimed to assess recent studies that analyzed vitamin D deficiency and heart failure in adult and pediatric populations. (2) Methods: We conducted a systematic search for studies published in the following databases: PubMed and Scopus from January 2012 to October 2022. (3) Results: Most observational studies that were included found a significant association between hypovitaminosis D and heart failure. However, the beneficial role of vitamin D supplementation is still controversial due to the lack of randomized controlled trials. (4) Conclusions: Vitamin D may play an important role as a cardiovascular marker in heart failure patients. More well-designed studies are needed to investigate the relationship between vitamin D and heart failure and to determine if vitamin D supplementation could improve long-term outcomes.

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Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline

Demay,

Pittas,

Bikle

et al. 2024

The Journal of Clinical Endocrinology &Amp; Metabolism

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Background Numerous studies demonstrate associations between serum concentrations of 25-hydroxyvitamin D (25[OH]D) and a variety of common disorders, including musculoskeletal, metabolic, cardiovascular, malignant, autoimmune, and infectious diseases. Although a causal link between serum 25(OH)D concentrations and many disorders has not been clearly established, these associations have led to widespread supplementation with vitamin D and increased laboratory testing for 25(OH)D in the general population. The benefit-risk ratio of this increase in vitamin D use is not clear, and the optimal vitamin D intake and the role of testing for 25(OH)D for disease prevention remain uncertain. Objective To develop clinical guidelines for the use of vitamin D (cholecalciferol [vitamin D3] or ergocalciferol [vitamin D2]) to lower the risk of disease in individuals without established indications for vitamin D treatment or 25(OH)D testing. Methods A multidisciplinary panel of clinical experts, along with experts in guideline methodology and systematic literature review, identified and prioritized 14 clinically relevant questions related to the use of vitamin D and 25(OH)D testing to lower the risk of disease. The panel prioritized randomized placebo-controlled trials in general populations (without an established indication for vitamin D treatment or 25[OH]D testing), evaluating the effects of empiric vitamin D administration throughout the lifespan, as well as in select conditions (pregnancy and prediabetes). The panel defined “empiric supplementation” as vitamin D intake that (a) exceeds the Dietary Reference Intakes (DRI) and (b) is implemented without testing for 25(OH)D. Systematic reviews queried electronic databases for publications related to these 14 clinical questions. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology was used to assess the certainty of evidence and guide recommendations. The approach incorporated perspectives from a patient representative and considered patient values, costs and resources required, acceptability and feasibility, and impact on health equity of the proposed recommendations. The process to develop this clinical guideline did not use a risk assessment framework and was not designed to replace current DRI for vitamin D. Results The panel suggests empiric vitamin D supplementation for children and adolescents aged 1 to 18 years to prevent nutritional rickets and because of its potential to lower the risk of respiratory tract infections; for those aged 75 years and older because of its potential to lower the risk of mortality; for those who are pregnant because of its potential to lower the risk of preeclampsia, intra-uterine mortality, preterm birth, small-for-gestational-age birth, and neonatal mortality; and for those with high-risk prediabetes because of its potential to reduce progression to diabetes. Because the vitamin D doses in the included clinical trials varied considerably and many trial participants were allowed to continue their own vitamin D–containing supplements, the optimal doses for empiric vitamin D supplementation remain unclear for the populations considered. For nonpregnant people older than 50 years for whom vitamin D is indicated, the panel suggests supplementation via daily administration of vitamin D, rather than intermittent use of high doses. The panel suggests against empiric vitamin D supplementation above the current DRI to lower the risk of disease in healthy adults younger than 75 years. No clinical trial evidence was found to support routine screening for 25(OH)D in the general population, nor in those with obesity or dark complexion, and there was no clear evidence defining the optimal target level of 25(OH)D required for disease prevention in the populations considered; thus, the panel suggests against routine 25(OH)D testing in all populations considered. The panel judged that, in most situations, empiric vitamin D supplementation is inexpensive, feasible, acceptable to both healthy individuals and health care professionals, and has no negative effect on health equity. Conclusion The panel suggests empiric vitamin D for those aged 1 to 18 years and adults over 75 years of age, those who are pregnant, and those with high-risk prediabetes. Due to the scarcity of natural food sources rich in vitamin D, empiric supplementation can be achieved through a combination of fortified foods and supplements that contain vitamin D. Based on the absence of supportive clinical trial evidence, the panel suggests against routine 25(OH)D testing in the absence of established indications. These recommendations are not meant to replace the current DRIs for vitamin D, nor do they apply to people with established indications for vitamin D treatment or 25(OH)D testing. Further research is needed to determine optimal 25(OH)D levels for specific health benefits.

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Is vitamin D deficiency a risk factor for all-cause mortality and rehospitalization in heart failure patients?: A systematic review and meta-analysis

Cited by 3 publications

References 24 publications

The interplay between bone and heart health as reflected in medication effects: A narrative review

The interplay between bone and heart health as reflected in medication effects: A narrative review

Is Hypovitaminosis D a Risk Factor for Heart Failure?

Vitamin D for the Prevention of Disease: An Endocrine Society Clinical Practice Guideline

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