Effect of Monthly High-Dose Vitamin D Supplementation on Cardiovascular Disease in the Vitamin D Assessment Study, A Randomized Clinical Trial
JAMA Cardiol. Published online April 5, 2017. doi:10.1001/jamacardio.2017.0175
Robert Scragg, MBBS, PhD1; Alistair W. Stewart, BSc1; Debbie Waayer, MEd1; et al Carlene M. M. Lawes, MBChB, PhD1; Les Toop, MBChB, MD2; John Sluyter, PhD1; Judy Murphy, RN1; Kay-Tee Khaw, MBBChir, MSc3; Carlos A. Camargo Jr, MD, DrPH4
- 4 years ago VitaminDWiki determined that monthly dosing is too infrequent
The study on this page, using monthly dosing, was started a year before that
- This study failed to include Vitamin K2 – which cleans blood vessels
- This study failed to include Magnesium – which cleans blood vessels
- This study failed to include Omega-3 – which prevents clogging of blood vessels
- It is likely that the blood measurements of vitamin D were too near to the time of taking the monthly supplement
– thus giving an artificially high reading (testing should not occur in less than 5 days)
- Low Vitamin K2 is as risky as smoking for heart disease - Oct 2016
- Cardiovascular Disease and Diabetes helped by Vitamin D – most 2013-15 studies agree
- Death from Coronary Heart Disease related to low Magnesium intake – March 2013
- Omega-3 – need more than 1 gram for a short time to reduce Cardiovascular Disease – Nov 2016
- Major heart problems avoided if have high vitamin D – 234,000 people Nov 2015
Cardiovascular category shows that there are many heart problems that vitamin D helps with
- Overview Cardiovascular and vitamin D
- Hypertension and vitamin D
- Overview Metabolic Syndrome and vitamin D
- Overview Stroke and vitamin D
- Peripheral arterial disease risk is 1.5X higher if low vitamin D – meta-analysis March 2018
- Peripheral Arterial Disease 3.7 X more likely in diabetics with low vitamin D – June 2019
- Heart attack ICU costs cut in half by Vitamin D – Oct 2018
- Heart Failure and Vitamin D meta-analyses - 2016, 2019
- Cardiovascular death 1.5X more likely if less than 20 ng of Vitamin D – 22nd meta-analysis Nov 2019
- Vitamin D supplementation reduces many Cardiovascular Disease markers– meta-analysis July 2018
- Cardiovascular Prevention with Omega-3 (finally using high doses) – Sept 2019
- Higher Omega-3 index (4 to 8 percent) associated with 30 percent less risk of coronary disease (10 studies) July 2017
A poor Vitamin D Receptor can block Vitamin D in blood from getting to tissues
- Heart Failure 15X more likely if poor VDR, even if good level of vitamin D (China) – March 2019
- Coronary Artery Disease without diabetes 5 times more likely if VDR gene problems – meta-analysis May 2016
- Cholesterol is needed to produce both Vitamin D and Cortisol
- Overview Cholesterol and vitamin D
- Statins and vitamin D statins often reduce levels of vitamin D
- Statin side-effects are reduced by Vitamin D – US patent Application – April 2019
- Question Does monthly high-dose vitamin D supplementation prevent cardiovascular disease?
- Findings In a randomized clinical trial that included 5108 participants from the community, the cumulative incidence of cardiovascular disease for a median follow-up period of 3.3 years was 11.8% among participants given 100 000 IU of vitamin D3 monthly and 11.5% among those given placebo.
- Meaning Monthly high-dose vitamin D supplementation did not prevent cardiovascular disease and should not be used for this purpose.
Importance Cohort studies have reported increased incidence of cardiovascular disease (CVD) among individuals with low vitamin D status. To date, randomized clinical trials of vitamin D supplementation have not found an effect, possibly because of using too low a dose of vitamin D.
Objective To examine whether monthly high-dose vitamin D supplementation prevents CVD in the general population.
Design, Setting, and Participants The Vitamin D Assessment Study is a randomized, double-blind, placebo-controlled trial that recruited participants mostly from family practices in Auckland, New Zealand, from April 5, 2011, through November 6, 2012, with follow-up until July 2015. Participants were community-resident adults aged 50 to 84 years. Of 47 905 adults invited from family practices and 163 from community groups, 5110 participants were randomized to receive vitamin D3 (n = 2558) or placebo (n = 2552). Two participants retracted consent, and all others (n = 5108) were included in the primary analysis.
Interventions Oral vitamin D3 in an initial dose of 200 000 IU, followed a month later by monthly doses of 100 000 IU, or placebo for a median of 3.3 years (range, 2.5-4.2 years).
Main Outcomes and Measures The primary outcome was the number of participants with incident CVD and death, including a prespecified subgroup analysis in participants with vitamin D deficiency (baseline deseasonalized 25-hydroxyvitamin D [25(OH)D] levels <20 ng/mL). Secondary outcomes were myocardial infarction, angina, heart failure, hypertension, arrhythmias, arteriosclerosis, stroke, and venous thrombosis.
Results Of the 5108 participants included in the analysis, the mean (SD) age was 65.9 (8.3) years, 2969 (58.1%) were male, and 4253 (83.3%) were of European or other ethnicity, with the remainder being Polynesian or South Asian. Mean (SD) baseline deseasonalized 25(OH)D concentration was 26.5 (9.0) ng/mL, with 1270 participants (24.9%) being vitamin D deficient. In a random sample of 438 participants, the mean follow-up 25(OH)D level was greater than 20 ng/mL higher in the vitamin D group than in the placebo group. The primary outcome of CVD occurred in 303 participants (11.8%) in the vitamin D group and 293 participants (11.5%) in the placebo group, yielding an adjusted hazard ratio of 1.02 (95% CI, 0.87-1.20). Similar results were seen for participants with baseline vitamin D deficiency and for secondary outcomes.
Conclusions and Relevance Monthly high-dose vitamin D supplementation does not prevent CVD. This result does not support the use of monthly vitamin D supplementation for this purpose. The effects of daily or weekly dosing require further study.
Trial Registration clinicaltrials.gov Identifier: ACTRN12611000402943