High-dose vitamin D improves heart structure, function in chronic heart failure
By: JENNIE SMITH, Cardiology News Digital Network APR 4, 2016
FROM ACC16
Ejection fraction (% of blood ejected for each pump of the heart)
- 60%-70% good heart
- 26% before start of trial and after 1 year of placebo
- 34% after 1 year of 4,000 IU of vitamin D
- However, no improvement in distance traveled for 6 minute walk
See also VitaminDWiki
- Risk of Cardiac failure reduced 20 percent by 800 IU of vitamin D and Calcium – meta-analysis July 2014
- Seniors with Heart Failure helped by daily 4,000 IU of vitamin D (increase 16 ng) – RCT Aug 2014
- More blood was pumped by those getting 800,000 IU of vitamin D after heart failure – RCT Oct 2013
- Chronic Heart Failure helped with 2,000 IU of vitamin D (PRA reduced) – RCT June 2013
- Heart failure 2X more likely if less than 20 ng of vitamin D – Sept 2012
perhaps vitamin D can PREVENT CHF - Death in less than 2 years of Heart Failure associated with low vitamin D - April 2012
- Patent for patients of Chronic Heart Failure includes vitamin D – June 2011
A patent is often a good indication that something actually works - 96 percent of heart failure patients had less than 30 ng of vitamin D – March 2011
- Chronic Heart Failure not treated by Vitamin D, if dose size is ignored – meta-analysis Oct 2015
- Overview Cardiovascular and vitamin D
- Overview Hypertension and Vitamin D
146 items - Overview Metabolic Syndrome and vitamin D
92 items - Overview Stroke and vitamin D
105 items - Cardiovascular Disease is treated by Vitamin D - review Oct 2021
- Arterial Stiffness and Vitamins – only Vitamin D was found to help – meta-analysis Feb 2022
- Those raising Vitamin D above 30 ng were 1.4 X less likely to die of Heart Attack (VA 19 years) – Oct 2021
- Giving free vitamin D to every Iranian would pay for itself by just reducing CVD – Oct 2021
- 26 health factors increase the risk of COVID-19 – all are proxies for low vitamin D
- Sudden Cardiac Arrest – 2.8 X higher risk if low vitamin D – 2019
- Cardiovascular death 1.5X more likely if less than 20 ng of Vitamin D – 22nd meta-analysis Nov 2019
- Peripheral arterial disease risk is 1.5X higher if low vitamin D – meta-analysis March 2018
- Heart attack ICU costs cut in half by Vitamin D – Oct 2018
Cardio Meta-analyses:
32 studies (auto-updated)
- Recurrrent Cardiovascular deaths cut in half if 10 ng more Vitamin D – meta-analysis Sept 2021
- Statin pain reduces Vitamin D levels by 4 ng ( 9 studies) - Meta-analysis July 2021
- Arterial stiffness reduced if use at least 2,000 IU of Vitamin D for 4 months – meta-analysis Dec 2019
- Blood vessels not helped by small vitamin D doses – meta-analysis Dec 2019
- Vitamin D supplementation reduces many Cardiovascular Disease markers– meta-analysis July 2018
- Low-dose vitamin D does not help cardiovascular (many were 100-1,000 IU) – meta-analysis June 2019
- Heart Failure and Vitamin D meta-analyses - 2016, 2019
- Vitamin K (across all dose sizes and types) decrease Vascular Stiffness – meta-analysis - Dec 2018
- Small or infrequent doses of vitamin D do not reduce heart failure much – meta-analysis Jan 2018
- Peripheral arterial disease risk is 1.5X higher if low vitamin D – meta-analysis March 2018
- Omega-3 reduced time in hospital and atrial fibrillation after cardiac surgery – meta-analysis May 2016
- Cardiovascular deaths 12 percent less likely if have 10 ng more vitamin D – meta-analysis March 2017
- Health problems prevented by eating nuts (perhaps due to Magnesium and or Omega-3) – meta-analysis Dec 2016
- Atrial Fibrillation 1.3 times more likely if low vitamin D – meta-analysis Sept 2016
- Coronary Artery Disease without diabetes 5 times more likely if VDR gene problems – meta-analysis May 2016
- Chronic Heart Failure not treated by Vitamin D, if dose size is ignored – meta-analysis Oct 2015
- Atrial fibrillation sometimes treated by Omega-3 – meta-analysis Sept 2015
- Peripheral Arterial Disease patients have low vitamin D levels – meta-analysis Oct 2015
- C-reactive protein (heart disease marker) reduced by vitamin D – meta-analysis 2014, 2019
- Cardiovascular disease associated with postmenopausal non-human primates – meta-analysis Jan 2015
- Adding Calcium does NOT cause cardiovascular problems (reverses their meta-analysis) – Dec 2014
- Statin pain associated with 10 ng less vitamin D – meta-analysis Oct 2014
- Risk of Cardiac failure reduced 20 percent by 800 IU of vitamin D and Calcium – meta-analysis July 2014
- Magnesium prevents cardiovascular events – Meta-analysis March 2013
- Cardiovascular disease 50 % more likely if low vitamin D - meta-analysis Nov 2012
- Omega-3 does not help heart patients – meta-analysis Sept 2012
- Half as many heart deaths for those with high levels of vitamin D – meta-analysis Sept 2012
- Shift workers 23 percent more likely to have cardiovascular events – meta-analysis July 2012
- Low density lipoprotein cholesterol is predictable from vitamin D levels – meta-analysis March 2012
- 800 IU Vitamin D does not help heart – meta-analysis Aug 2011
- Calcium without vitamin D increased heart risk by 30 percent - Jan 2011
- Meta-analysis unsure if vitamin D can prevent cardiovascular disease – Sept 2010
Cholesterol, Statins
- Cholesterol is needed to produce both Vitamin D and Cortisol
- Overview Cholesterol and vitamin D
- Statins and vitamin D statins often reduce levels of vitamin D
- Statin side-effects are reduced by Vitamin D – US patent Application – April 2019
68 proofs that Vitamin D works (as of March 2016)
Proof that Vitamin D Works has the following concerning the heartHealth Problem Treat
PreventReduction
click for detailsRCT = Random Controlled Trial
* = link to additional RCT
CT = Clinical TrialVitamin
DWiki
#Hypertension T 149 to 142 mm Hg RCT* *, 2400 IU. 100,000 IU* 1 Cardiovascular after attack T 32 % fewer deaths CT 1000 IU 2 Diabetes T2 T 62 % RCT* *, CRP reduction, 4000 IU 4 Congestive Heart Failure T 90 % RCT, 1000 IU infants (also: Adults, not RCT) 27 After Heart Attack T __ +6% ejection fraction RCT, 800,000 IU one time 34  Download the Study PDF from VitaminDWiki
Key clinical point: Oral supplementation of high-dose vitamin D3 led to significantly improved left ventricular function and structure in a cohort of vitamin-deficient patients.
Major finding: Treated patients had significantly improved left ventricular ejection fraction of +6.07% vs. nontreated patients at 1 year, and significant reversal of left ventricular remodeling (left ventricular end diastolic diameter –2.49 mm and left ventricular end systolic diameter –2.09 mm).
Data source: A single-site randomized trial in which 229 patients with LV CHF received high-dose vitamin D or placebo for 12 months.
Disclosures: The U.K.’s National Institute for Health Research supported the study, and none of its authors declared conflicts of interest.High-dose oral vitamin D supplements taken for 1 year significantly improved cardiac structure and function in patients with chronic heart failure secondary to left ventricular systolic dysfunction, according to results from a new study.
However, the same study. led by Dr. Klaus Witte of the University of Leeds (England), found that 6-minute walk distance – the study’s primary outcome measure – was not improved after a year’s supplementation with vitamin D.
It is unclear why vitamin D deficiency co-occurs in a majority of people with chronic heart failure (CHF) due to left ventricular systolic dysfunction (LVSD) or to what degree reversing it can improve outcomes. However, vitamin D deficiency is thought to interfere with calcium transport in cardiac cells, and may contribute to cardiac fibrosis and inflammation, leading to faster progression to heart failure following damage to cardiac muscle.
The new VINDICATE study randomized 223 patients with CHF due to LVSD and vitamin D deficiency to 1 year’s treatment with 4,000 IU of 25(OH) vitamin D3 daily, or placebo, Dr. Witte and associates concluded at the annual meeting of the American College of Cardiology. The results were published online April 4 in JACC (doi: 10.1016/j.jacc.2016.03.508).Of these patients, 163 completed follow-up at 12 months, and 6-minute walk distance (MWT) and echocardiography findings were recorded at baseline and follow-up.
Dr. Witte and colleagues found significant evidence of improved function in the vitamin D–treated patients as measured by left ventricular ejection fraction +6.07% (95% confidence interval 3.20, 8.95; P less than .0001); and a reversal of left ventricular remodeling (left ventricular end diastolic diameter –2.49 mm (95% CI –4.09, –0.90; P equal to .002) and left ventricular end systolic diameter –2.09 mm (95% CI –4.11; –0.06; P equal to .043).
The researchers also drew blood at 3-month intervals to check for serum calcium concentration, renal function, and vitamin D levels. Treatment was well tolerated, and no patients suffered hypervitaminosis or required a dose adjustment.
“There was no effect of vitamin D supplementation on the primary endpoint of 6 MWT distance but there were statistically significant, and prognostically and clinically relevant improvements in the secondary outcomes of left ventricular ejection fraction, dimensions, and volumes, suggesting that vitamin D is leading to beneficial reverse remodeling,” the investigators wrote in their analysis.
The study’s failure to meet its primary endpoint despite significant results from its secondary endpoints led Dr. Witte and colleagues to say that its design led to underpowering.
“Variability in the walk distance measure at baseline was much greater than predicted from our pilot study such that our sample size only had 7% post hoc power to detect a difference between the groups,” meaning it was underpowered to detect a clinically relevant change in walk distance. The findings “have implications for future studies using 6-minute walk distance as an outcome measure,” they wrote.
The investigators championed the addition of vitamin D3 to CHF treatment regimens.
As new therapies for CHF are “often expensive, increasingly technical, and frequently fail to meet the rigorous demands of large phase III clinical trials,” Dr. Witte and colleagues wrote, vitamin D “might be a cheap and safe additional option for CHF patients and may have beneficial effects on multiple features of the syndrome.”
The U.K.’s National Institute for Health Research supported the study, and none of its authors declared conflicts of interest.http://content.onlinejacc.org/article.aspx?articleID=2507290#tab1Publisher wants for PDF
clips from Science Daily on the study
- The ejection fraction of a healthy person is usually between 60% and 70%. In heart failure patients, the ejection fraction is often significantly impaired — in the patients enrolled into the VINDICATE study the average ejection fraction was 26%.
- In the 80 patients who took Vitamin D3, the heart's pumping function improved from 26% to 34%. In the others, who took placebo, there was no change in cardiac function.
- This means that for some heart disease patients, taking vitamin D3 regularly may lessen the need for them to be fitted with an implantable cardioverter defibrillator (ICD), a device which detects dangerous irregular heart rhythms and can shock the heart to restore a normal rhythm.
- Heart failure affects about 900,000 people in the UK and more than 23 million worldwide.
- The condition can affect people of all ages, but it is more common in older people — more than half of all people globally with heart failure are over the age of 75.
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