Heart failure among 137 seniors 12X more likely if low vitamin D – Aug 2017

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Heart failure among 137 seniors 12X more likely if low vitamin D – Aug 2017

Association between vitamin D deficiency and heart failure risk in the elderly
ESC Heart Failure, First published: 17 August 2017, DOI: 10.1002/ehf2.12198
Catarina Magalhães Porto, Vanessa De Lima Silva, João Soares Brito da Luz, Brivaldo Markman Filho, Vera Magalhães da Silveira

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Aims
The aim of this study was to evaluate the association between vitamin D deficiency and risk of heart failure in elderly patients of cardiology outpatient clinics.

Methods and results
A cross-sectional study with an analytical approach was employed. Clinical data were collected from the elderly from August 2015 to February 2016. The dependent variable was the risk of heart failure; the independent variable was vitamin D deficiency; and intervening factors were age, gender, education, ethnicity, hypertension, diabetes mellitus, hypothyroidism, renal failure, dementia, stroke, dyslipidaemia, depression, smoking, alcoholism, obesity, andropause, and cardiac arrhythmia.
To analyse the association between vitamin D deficiency and risk of heart failure, we used the bivariate logistic analysis, followed by analysis through the multivariate logistic regression model.
Of the 137 elderly, the study found the following:

• women (75.9%);
• overweight (48.2%);
• obese (30.6%);
• increase in the index waist/hip (88.3%);
• dyslipidaemia (94.2%) and
• hypertension (91.2%);
• coronary artery disease (35.0%); and
• 27.7% with cardiac arrhythmia or left ventricular hypertrophy.

Sixty-five per cent of the elderly were deficient in vitamin D.
The risk of heart failure was significantly associated with

• vitamin D deficiency [odds ratio (OR): *12.19; 95% confidence interval (CI) = 4.23–35.16; P = 0.000],
• male gender (OR: 15.32; 95% CI = 3.39–69.20, P = 0.000),
• obesity (OR: 4.17; 95% CI = 1.36–12.81; P = 0.012), and
• cardiac arrhythmia (OR: 3.69; 95% CI = 1.23–11.11; P = 0.020).

Conclusions
There was a high prevalence of vitamin D deficiency in the elderly, and the evidence shows a strong association between vitamin D deficiency and increased risk of heart failure in this population.

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Heart Failure in Italy 66 % more likely if <10 ng of vitamin D – March 2018

Serum vitamin D deficiency and risk of hospitalization for heart failure: Prospective results from the Moli-sani study
Nutrition, Metabolism and Cardiovascular Diseases, Vol 28, Issue 3, March 2018, Pages 298-307, https://doi.org/10.1016/j.numecd.2017.11.008

Highlights

• Findings from epidemiological studies on Vitamin D deficiency and risk of heart failure (HF) are controversial.
• In Italian adults, levels of Vitamin D (<10 ng/mL) was associated with a higher risk (+61%) of hospitalization for HF.
• Adjustment for subclinical inflammation did not substantially change the association between Vitamin D deficiency and HF.

Background and aims
Evidence indicates that Vitamin D deficiency may be associated with increased risk of cardiovascular disease, although findings on risk of heart failure (HF) are controversial. We investigated the relationship between serum Vitamin D and the incidence of hospitalization for HF in a large prospective cohort of Italian adults.

Methods and results
19,092 (49% men, age range 35–99 years) HF-free individuals from the Moli-sani study, with complete data on serum Vitamin D (25-hydroxyvitamin) levels and incident hospitalized HF, were analysed. The cohort was followed up for a median of 6.2 years. Baseline serum Vitamin D levels were categorized in deficient (<10 ng/mL), insufficient (10–29 ng/mL), and normal (≥30 ng/mL) Incident cases of hospitalization for HF were identified by linkage with the regional hospital discharge registry. Hazard ratios (HRs) were calculated using Cox-proportional hazard models. The prevalence of normal, insufficient or deficient levels of Vitamin D was 12.2%, 79.6% and 8.2%, respectively. During follow-up, 562 admissions to hospital for HF were identified. The incidence of HF was 1.6%, 2.9% and 5.3%, respectively in subjects with normal, insufficient and deficient levels of Vitamin D. After multivariable analysis, individuals with deficiency of Vitamin D had a higher risk of hospitalization for HF (HR: 1.61, 95%CI: 1.06–2.43) than those with normal levels. Further adjustment for subclinical inflammation did not substantially change the association between Vitamin D deficiency and HF.

Conclusion
Deficiency of Vitamin D was associated, independently of known HF risk factors, with an increased risk of hospitalization for HF in an Italian adult population.