Heart Failure with depression increases risk of death by 9.5 X if low vitamin D – Aug 2017

Vitamin D supplements reduce depressive symptoms and cardiac events in heart failure patients with moderate to severe depressive symptoms.

Eur J Cardiovasc Nurs. 2017 Aug 1:1474515117727741. doi: 10.1177/1474515117727741. [Epub ahead of print]

Study is available at SciHub and at the bottom of this page

Song EK1, Wu JR2, Moser DK3, Kang SM4, Lennie TA3.
1 Department of Nursing, University of Ulsan, Korea.
2 School of Nursing, University of North Carolina at Chapel Hill, USA.
3 College of Nursing, University of Kentucky, USA.
4 Cardiology Division, Severance Hospital, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Korea.

Death of CF patients with moderate to severe depression

Note Adequate is defined by this study as > 400 IU from dietary sources
Far greater separation of variables on the chart expected if blood test measurements had been used

BACKGROUND:
Depressive symptoms and vitamin D deficiency predict cardiac events in heart failure patients, but whether vitamin D supplements are associated with depressive symptoms and cardiac events in heart failure patients remains unknown.

PURPOSE:
The purpose of this study was to compare the association of vitamin D supplement use with depressive symptoms and cardiac events in heart failure patients with mild or moderate to severe depressive symptoms.

METHODS:
A total of 177 heart failure patients with depressive symptoms (Patient Health Questionnaire-9 score ≥5) completed a three-day food diary to determine dietary vitamin D deficiency. Patients were split into four groups by dietary vitamin D adequacy versus deficiency and vitamin D supplement use versus non-use. The Patient Health Questionnaire-9 was used to reassess depressive symptoms at six months. Data on cardiac events for up to one year and vitamin D supplement use were obtained from patient interview and medical record review. Hierarchical linear and Cox regressions were used for data analysis.

RESULTS:
Sixty-six patients (37.3%) had dietary vitamin D deficiency and 80 (45.2%) used vitamin D supplements. In patients with moderate to severe depressive symptoms, the group with dietary vitamin D deficiency and no supplements had the highest Patient Health Questionnaire-9 score at six months (β=0.542, p<0.001) and shortest cardiac event-free survival ( p<0.001) among the four groups, the group with dietary vitamin D deficiency and no supplements didn't have the highest Patient Health Questionnaire-9 score at six months and shortest cardiac event-free survival in patients with mild depressive symptoms.

CONCLUSIONS:
Vitamin D supplements predicted lower depressive symptoms and reduced cardiac events for patients with moderate to severe depressive symptoms. Vitamin D deficiency was associated with higher risk of shorter cardiac event-free survival in heart failure patients regardless of vitamin D supplementation.

PMID: 28829157 DOI: 10.1177/1474515117727741