Vitamin D Supplementation in the Treatment of Chronic Heart Failure: A Meta-analysis of Randomized Controlled Trials
Clin Cardiol. 2016 Jan;39(1):56-61. doi: 10.1002/clc.22473. Epub 2015 Sep 28.
Jiang WL1, Gu HB2, Zhang YF1, Xia QQ1, Qi J3, Chen JC2.
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.
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.
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.
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Effect of vitamin D on ventricular remodelling in heart failure: a meta-analysis of randomised controlled trials.
BMJ Open. 2018 Aug 30;8(8):e020545. doi: 10.1136/bmjopen-2017-020545.
Zhao JD1, Jia JJ1, Dong PS1, Zhao D1, Yang XM1, Li DL1, Zhang HF1.
OBJECTIVES: The level of vitamin D is considered to be associated with the development and progression of heart failure (HF). However, it is still unclear whether supplementation of vitamin D could improve ventricular remodelling in patients with HF. This study aimed to systematically evaluate the influence and safety of additional vitamin D supplementation on ventricular remodelling in patients with HF.
DESIGN: This study is a meta-analysis of randomised controlled trials (RCTs).
SETTING: The PubMed, EMBASE, CNKI, Cochrane library, Web of Science databases and grey literature were searched for RCTs regarding the effect of vitamin D on ventricular remodelling in patients with HF (from database creation to October 2017). RevMan V.5.3 software was employed for data analysis.
PARTICIPANTS: Seven RCTs with a total of 465 patients, including 235 cases in the vitamin D group and 230 cases in the control group, were included.
PRIMARY AND SECONDARY OUTCOME MEASURES: Left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and the incidence of adverse reactions.
Compared with the control group, a decrease in the LVEDD (mean difference (MD)=-2.31 mm, 95% CI -4.15 to -0.47, p=0.01) and an increase in the LVEF (MD=4.18%, 95% CI 0.36 to 7.99, p=0.03) were observed in the vitamin D group. Subgroup analysis also revealed a reduced LVEDD in adults (>18 years) and adolescents (<18 years) of the vitamin D group relative to that in those of the control group. High-dose vitamin D (>4000 IU/day) was more effective at reducing the LVEDD than low-dose vitamin D (<4000 IU/day). Moreover, vitamin D supplementation was more effective at reducing the LVEDD and increasing the LVEF in patients with reduced ejection fraction than in patients without reduced ejection fraction.
CONCLUSION: Vitamin D supplementation inhibits ventricular remodelling and improves cardiac function in patients with HF.
TRIAL REGISTRATION NUMBER: CRD42017073893.
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- Vitamin D augmented conventional Congestive Heart Failure treatment in perhaps 10 ways – case reports April 2017
- Heart Failure and Vitamin D meta-analyses - 2016, 2018
- Vascular calcification reduced by Vitamin K – 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 June 2014
- 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 even a small amount of vitamin D – 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