Friday, June 1, 2012

Vitamin D more maybe's

Vitamin  D and Blood Pressure

Vitamin D and blood pressure 
This article reviewed  a number of studies that discuss " the association " of increased Blood pressure and low 25(OH ) vitamin D levels  < 30 ng/ml .

This study documented the Circulating 25-Hydroxyvitamin D Concentrations Are Correlated With Cardiometabolic Risk Among American Black and White Adolescents Living in a Year-Round Sunny Climate
Samip Parikh MBBS, De-huang Guo MD, Norman K. Pollock PHD, Karen Petty PHD, Jigar Bhagatwala MBBS, Bernard Gutin PHD, Chris Houk MD, Haidong Zhu MD, Yanbin Dong MD
 in young adults.

Vitamin D and the risk of developing Heart Disease
 I have attached a couple of abstracts discussing " maybe's " and" the association" of Vitamin  D deficiency and the increased risk of heart disease.  I believe that a lot of excellent work has been done associating Vitamin D with health problems other than just bone health. We have reviewed these Associations and Maybes over the last few days. There is still a lot of work to be done before we understand these associations and more importantly , we need good studies demonstrating the benefits or lack of benefit  of taking Vitamin D supplements . Most Vitamin supplements seem to be strong on hype and low in actual benefit.

What to do now.
    Having a Vitamin D test  ( 25(  [OH ] D)  done seems reasonable to me.
    Getting a little more sunshine , taking Vitamin D supplements  and getting followup test is  
    something  that needs to be  discussed with your doctor.

Have fun , Be Smart  and discuss these  "Maybe's " with your doctor
David Calder, MD

A few Studies

25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study.


Department of Nutrition, Harvard School of Public Health, 665 Huntington Ave, Boston, MA 02115,



Vitamin D deficiency "may be "involved in the development of atherosclerosis and coronary heart disease in humans.


We assessed prospectively whether plasma 25-hydroxyvitamin D (25[OH]D) concentrations are associated with risk of coronary heart disease. A nested case-control study was conducted in 18,225 men in the Health Professionals Follow-up Study; the men were aged 40 to 75 years and were free of diagnosed cardiovascular disease at blood collection. The blood samples were returned between April 1, 1993, and November 30, 1999; 99% were received between April 1, 1993, and November 30, 1995. During 10 years of follow-up, 454 men developed nonfatal myocardial infarction or fatal coronary heart disease. Using risk set sampling, controls (n = 900) were selected in a 2:1 ratio and matched for age, date of blood collection, and smoking status.


After adjustment for matched variables, men deficient in 25(OH)D (<or=15 ng/mL [to convert to nanomoles per liter, multiply by 2.496]) were at increased risk for MI compared with those considered to be sufficient in 25(OH)D (>or=30 ng/mL) (relative risk [RR], 2.42; 95% confidence interval [CI], 1.53-3.84; P < .001 for trend). After additional adjustment for family history of myocardial infarction, body mass index, alcohol consumption, physical activity, history of diabetes mellitus and hypertension, ethnicity, region, marine omega-3 intake, low- and high-density lipoprotein cholesterol levels, and triglyceride levels, this relationship remained significant (RR, 2.09; 95% CI, 1.24-3.54; P = .02 for trend). Even men with intermediate 25(OH)D levels were at elevated risk relative to those with sufficient 25(OH)D levels (22.6-29.9 ng/mL: RR, 1.60 [95% CI, 1.10-2.32]; and 15.0-22.5 ng/mL: RR, 1.43 [95% CI, 0.96-2.13], respectively).


Low levels of 25(OH)D " " with higher risk of myocardial infarction in a graded manner, even after controlling for factors known to be associated with coronary artery disease.

Vitamin D, race, and cardiovascular mortality: findings from a national US sample.


Department of Family Medicine and Department of Community & Preventive Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.



Findings are conflicting about the relationship between vitamin D levels and cardiovascular mortality. We wanted to determine the contribution of vitamin D levels to black-white disparities in cardiovascular mortality.


We examined the association of serum 25(OH)D levels with cardiovascular mortality and its contribution to elevated risk among blacks through a retrospective cohort using baseline data from the third National Health and Nutrition Examination Survey 1988-1994 and cause-specific mortality through 2001 using the National Death Index. Using piecewise Poisson regression models, we examined the risk of cardiovascular death (coronary heart disease, heart failure, and stroke) by sample 25(OH)D quartile, adjusting for cardiovascular risk factors, and compared models of adjusted race-related cardiovascular mortality with and without further adjustment for 25(OH)D levels.


Participants with 25(OH)D levels in the lowest quartile (mean = 13.9 ng/mL) compared with those in the 3 higher quartiles (mean = 21.6, 28.4, and 41.6 ng/mL) had higher adjusted risk of cardiovascular death (incident rate ratio [IRR] = 1.40; 95% confidence interval [CI], 1.16-1.70). The higher age- and sex-adjusted cardiovascular mortality observed in blacks vs whites (IRR = 1.38; 95% CI, 1.13-1.70) was attenuated (IRR = 1.14; 95% CI, 0.91-1.44) by adjustment for 25(OH)D levels and fully eliminated with further adjustment for income (IRR=1.01; 95% CI, 0.82-1.24).


Low serum levels of 25(OH)D are associated with increased cardiovascular mortality in a nationally representative US sample. Black-white differences in 25(OH)D levels may contribute to excess cardiovascular mortality in blacks. Interventional trials among persons with low vitamin D levels are needed to determine whether oral supplementation improves cardiovascular outcomes.

1 comment:

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Your comments and questions are appreciated. David Calder,MD