Vitamin D Supplementation in the Treatment of Chronic Heart Failure: A Meta‐analysis of Randomized Controlled Trials

Abstract

Background: In recent years, there has been growing evidence that vitamin D deficiency is associated with the development and progression of chronic heart failure (CHF). Hypothesis: Additional supplementation of vitamin D may have protective effects in patients with CHF. Methods: We searched PubMed, Embase, and Cochrane databases through June 2015 and included 7 randomized controlled trials that investigated the effects of vitamin D on cardiovascular outcomes in patients with CHF. Then, we performed a meta-analysis of clinical trials to confirm whether vitamin D supplementation is beneficial in CHF patients. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using fixed-or random-effects models. Results: Our pooled results indicated that additional supplementation of vitamin D was not superior to conventional treatment in terms of left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide, and 6-minute walk distance. Moreover, vitamin D supplementation was associated with significant decreases in the levels of tumor necrosis factor-α (WMD: −2.42 pg/mL, 95% CI: −4.26 to −0.57, P < 0.05), C-reactive protein (WMD: −0.72 mg/L, 95% CI: −1.42 to −0.02, P < 0.05), and parathyroid hormone (WMD: −13.44 pg/mL, 95% CI: −21.22 to −5.67, P < 0.05). Conclusions: Vitamin D supplementation may decrease serum levels of parathyroid hormone and inflammatory mediators in CHF patients, whereas it has no beneficial effects on improvement of left ventricular function and exercise tolerance.

Effect of vitamin D on ventricular remodelling in heart failure: a meta-analysis of randomised controlled trials

“…In the 2014 World Heart Failure Conference, Louise et al 42 reported an RCT that performed a 6-month study on 32 patients with HF, and the result showed that supplementation of vitamin D did not improve the LVEF or pro-BNP level. A recent meta-analysis43 also reported that vitamin D supplementation could not improve the LVEF (WMD: 4.11%, 95% CI −0.91 to 9.12, p=0.11) and 6-minute walk distance (6MWD) (WMD: 8.90 m, 95% CI: −48.47 to 66.26, p=0.76) in the treatment of chronic HF. In contrast, this study included three other studies, two of which showed a positive effect from vitamin D supplementation.…”

Role of Vitamin D in Cardiovascular Diseases

“…Further, as discussed earlier, vitamin D deficiency associates with HF, and vitamin D supplementation may be beneficial [84]. However, there are reports of no improvement or beneficial effect of vitamin D in HF with vitamin D supplementation, and the discrepancies between the studies may be due to the genetic variations in the VDR (eg.…”

Vitamin D deficiency is an independent predictor of mortality in patients with chronic heart failure

“…Recent meta-analyses have suggested that vitamin D might reduce inflammation (assessed by tumour necrosis factor-alpha levels (TNF-α) [60]), but that it is neutral for heart function [61]. However, the latter analysis did not include data from the VINDICATE paper which presented data from two independent randomised, placebocontrolled, double-blind, parallel group studies using two imaging modalities demonstrating consistent improvements in left ventricular structure and function [9].…”