Cardiovascular events – need more than monthly 60,000 IU vitamin D to prevent other than infarction – June 2023

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Vitamin D supplementation and major cardiovascular events: D-Health randomised controlled trial

BMJ 2023; 381 doi: https://doi.org/10.1136/bmj-2023-075230 (Published 28 June 2023)
Bridie Thompson, research officer1, Mary Waterhouse, statistician epidemiologist1, Dallas R English, professor2, Donald S McLeod, senior research officer1, Bruce K Armstrong, professor3, Catherine Baxter, project manager1, Briony Duarte Romero, research assistant1, Peter R Ebeling, professor4, Gunter Hartel, head of statistics5, Michael G Kimlin, professor6, Sabbir T Rahman, research officer1, Jolieke C van der Pols, associate professor7, Alison J Venn, professor8, Penelope M Webb, professor1, David C Whiteman, professor1, Rachel E Neale, professor1 rachel.neale at qimrberghofer.edu.au

Objective To investigate whether supplementing older adults with monthly doses of vitamin D alters the incidence of major cardiovascular events.

Design Randomised, double blind, placebo controlled trial of monthly vitamin D (the D-Health Trial). Computer generated permuted block randomisation was used to allocate treatments.

Setting Australia from 2014 to 2020.

Participants 21 315 participants aged 60-84 years at enrolment. Exclusion criteria were self-reported hypercalcaemia, hyperparathyroidism, kidney stones, osteomalacia, sarcoidosis, taking >500 IU/day supplemental vitamin D, or unable to give consent because of language or cognitive impairment.

Intervention 60 000 IU/month vitamin D3 (n=10 662) or placebo (n=10 653) taken orally for up to five years. 16 882 participants completed the intervention period: placebo 8270 (77.6%); vitamin D 8552 (80.2%).

Main outcome measures The main outcome for this analysis was the occurrence of a major cardiovascular event, including myocardial infarction, stroke, and coronary revascularisation, determined through linkage with administrative datasets. Each event was analysed separately as secondary outcomes. Flexible parametric survival models were used to estimate hazard ratios and 95% confidence intervals.

Results 21 302 people were included in the analysis. The median intervention period was five years. 1336 participants experienced a major cardiovascular event (placebo 699 (6.6%); vitamin D 637 (6.0%)). The rate of major cardiovascular events was lower in the vitamin D group than in the placebo group (hazard ratio 0.91, 95% confidence interval 0.81 to 1.01), especially among those who were taking cardiovascular drugs at baseline (0.84, 0.74 to 0.97; P for interaction=0.12), although the P value for interaction was not significant (<0.05). Overall, the difference in standardised cause specific cumulative incidence at five years was −5.8 events per 1000 participants (95% confidence interval −12.2 to 0.5 per 1000 participants), resulting in a number needed to treat to avoid one major cardiovascular event of 172. The rate of myocardial infarction (hazard ratio 0.81, 95% confidence interval 0.67 to 0.98) and coronary revascularisation (0.89, 0.78 to 1.01) was lower in the vitamin D group, but there was no difference in the rate of stroke (0.99, 0.80 to 1.23).

Conclusions Vitamin D supplementation might reduce the incidence of major cardiovascular events, although the absolute risk difference was small and the confidence interval was consistent with a null finding. These findings could prompt further evaluation of the role of vitamin D supplementation, particularly in people taking drugs for prevention or treatment of cardiovascular disease.

Trial registration ACTRN12613000743763
 Download the PDF from VitaminDWiki

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Known to have less benefit if dose >17 days, obese, dark skin, poor gut, taking statins, etc.

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VitaminDWiki - 8 Studies using non-daily Intervention in Cardiovascular

This list is automatically updated

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VitaminDwiki – Cardiovascular category contains

520 items In Cardiovascular category

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

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229+ VitaminDwiki pages have 50,000 or 60,000 IU in their title

Note: India uses 60,000 IU capsules