Effect of vitamin D on all-cause mortality in heart failure (EVITA): a 3-year randomized clinical trial with 4000 IU vitamin D daily.
Eur Heart J. 2017 May 12. doi: 10.1093/eurheartj/ehx235. [Epub ahead of print]
Zittermann A1 , Ernst JB1, Prokop S1, Fuchs U1, Dreier J2, Kuhn J2, Knabbe C2, Birschmann
I2, Schulz U1, Berthold HK3, Pilz S4, Gouni-Berthold I5, Gummert JF1, Dittrich M6, Börgermann J1.
This RCT did NOT find a benefit
Many strange things
- The RCT listing only mentions Ergocalciferols, but not D3, yet the publication says it used D3
- More that half of the people decided to not participate in the RCT. A study has found serious problems with RCT results when so many did not participate
- This RCT selected only those people with chronic heart failure (80% had pacemakers), not the general public. Perhaps people with chronic heart failure are more likely to have poor a Vitamin D Receptor than the healthy public, and thus would need significantly higher levels of Vitamin D (> 50 ng?) to get enough Vitamin D to their heart cells.
- The average vitamin D level achieved was 40 ng – where Vitamin D starts to help the healthy
RCT failed to compare results for those < 40 ng and > 40 ng - About 45% of the participants did not continue to take the vitamin D for the entire RCT - were those people healthier?
See also VitaminDWiki
Items in both categories Cardiovascular and Intervention are listed here:
- Vitamin D Has No Effect on Cardiovascular Health (20 studies disagree) - Nov 2024
- Cardiovascular events – need more than monthly 60,000 IU vitamin D to prevent other than infarction – June 2023
- High dose vitamin D fights Folate gene changes by COVID, autoimmune, CVD, ALZ – Oct 2022
- 3,200 IU of daily not help much in population already having 30 ng of Vitamin D – RCT Jan 2022
- Atrial Fibrillation risk reduced by 0.84 in those raising Vitamin D levels above 30 ng – RCT April 2022
- Monthly vitamin D helped hearts with low vitamin D a bit (need it more frequently) – RCT March 2022
- 50,000 IU of vitamin D weekly following cardiac failure helps – RCT 2014
- 50,000 IU of Vitamin D weekly for 9 weeks did not improve CVD – Aug 2018
- Cardiovascular risk markers not helped by 20,000 IU of vitamin D weekly – RCT May 2018
- Heart attack ICU costs cut in half by Vitamin D – Oct 2018
- Hypertension not controlled by 26 ng of Vitamin D (50,000 IU bi-weekly A-A) – RCT Nov 2017
- Heart Failure not helped by Vitamin D (several strange things about the trial) – RCT May 2017
- Chronic Heart Failure reduced by 4,000 IU daily for a year – RCT April 2016
- Cardiovascular death reduction in dark skin migrants by just 1,000 IU of vitamin D – May 2015
- Heart failure markers reduced by 400 IU of vitamin D and Calcium (surprise) – RCT Jan 2015
- Angina dramatically reduced by injections of vitamin D twice a month (300,000 IU) – Jan 2015
- Salmon intervention (vitamin D and Omega-3) improved heart rate variability and reduced anxiety – Nov 2014
- 1700 IU vitamin D for a year provided no cardiovascular benefit (no surprise) – RCT Oct 2014
- Seniors with Heart Failure helped by daily 4,000 IU of vitamin D (increase 16 ng) – RCT Aug 2014
- Hearts responded to stress better after 5,000 IU of vitamin D for a month - March 2014
- More blood was pumped by those getting 800,000 IU of vitamin D after heart failure – RCT Oct 2013
- Off Topic: EDTA similar reduction in heart attack as Vitamin C, aspirin and Mg – RCT March 2013
- Chronic Heart Failure helped with 2,000 IU of vitamin D (PRA reduced) – RCT June 2013
- 4000 IU vitamin D daily for just 5 days reduced inflammation after heart attack – RCT Jan 2013
- Congestive heart failure in infants virtually cured by 1000 IU of vitamin D – RCT Feb 2012
- Chance of death after heart failure reduced by 1000 IU of vitamin D – Feb 2012
Cardiovascular category in VitaminDWiki starts with the following
Cardiovascular category is associated with other categories: Diabetes 31, Omega-3 31 , Vitamin K 25 , Intervention 22 . Mortality 20 , Skin - Dark 18 , Magnesium 17 , Calcium 14 , Hypertension 14 , Trauma and surgery 13 , Stroke 13 , Kidney 12 , Metabolic Syndrome 11 , Seniors 10 , Pregnancy 8 as of Aug 2022
- Overview Cardiovascular and vitamin D
- Cardiovascular Disease is treated by Vitamin D - many studies 39+ meta-analyses
- Coronary Artery Disease and Vitamin D - many studies 18+
- Cardiovascular problems reduced by Omega-3 - many studies 34+
- Arteries and Atherosclerosis and Vitamin D - many studies 71+
- Atrial Fibrillation decreased by Vitamin D or Magnesium - many studies 26+
- Statins and Vitamin D - many studies 25+
- 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
- Sudden Cardiac Arrest – 2.8 X higher risk if low vitamin D – 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
- Cardiovascular disease 2.3 X more-likely if poor Vitamin D Receptor – Aug 2022
Cholesterol, Statins
- Cholesterol is needed to produce both Vitamin D and Cortisol
- Overview Cholesterol and vitamin D
- Statins and Vitamin D - many studies statins often reduce levels of vitamin D
- Statin side-effects are reduced by Vitamin D – US patent Application – April 2019
A few of the Meta-analyses of Vitamin D and Cardiovascular problems
- Cardiovascular deaths 12 percent less likely if have 10 ng more vitamin D – meta-analysis March 2017
- C-reactive protein (heart disease marker) reduced by vitamin D – meta-analysis 2014, 2019
See also Vitamin D Council on this study
AIMS:
Circulating 25-hydroxyvitamin D (25OHD) levels <75 nmol/L are associated with a nonlinear increase in mortality risk. Such 25OHD levels are common in heart failure (HF). We therefore examined whether oral vitamin D supplementation reduces mortality in patients with advanced HF.
METHODS AND RESULTS:
Four hundred HF patients with 25OHD levels <75 nmol/L were randomized to receive 4000 IU vitamin D daily or matching placebo for 3 years. Primary endpoint was all-cause mortality.
Key secondary outcome measures included, hospitalization, resuscitation, mechanical circulatory support (MCS) implant, high urgent listing for heart transplantation, heart transplantation, and hypercalcaemia.
Initial 25OHD levels were on average <40 nmol/L, remained around 40 nmol/L in patients assigned to placebo and plateaued around 100 nmol/L in patients assigned to vitamin D.
Mortality was not different in patients receiving vitamin D (19.6%; n = 39) or placebo (17.9%; n = 36) with a hazard ratio (HR) of 1.09 [95% confidence interval (CI): 0.69-1.71; P = 0.726].
The need for MCS implant was however greater in patients assigned to vitamin D (15.4%, n = 28) vs. placebo [9.0%, n = 15; HR: 1.96 (95% CI: 1.04-3.66); P = 0.031].
Other secondary clinical endpoints were similar between groups. The incidence of hypercalcaemia was 6.2% (n = 10) and 3.1% (n = 5) in patients receiving vitamin D or placebo (P = 0.192).
CONCLUSION:
A daily vitamin D dose of 4000 IU did not reduce mortality in patients with advanced HF but was associated with a greater need for MCS implants. Data indicate caution regarding long-term supplementation with moderately high vitamin D doses.
Trial listing: NCT01326650
PMID: 28498942 DOI: 10.1093/eurheartj/ehx235 Publisher wants $42 for the PDF
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