Cardiology Volume 122, Issue 21 Supplement; November 23, 2010 / Abstracts From Scientific Sessions 2010
Core 2. Epidemiology and Prevention of CV Disease: Physiology, Pharmacology and Lifestyle
Subba Reddy Vanga; Matthew Good; Dhanunjaya Lakkireddy; Patricia Howard; James L Vacek
Univ of Kansas Med Cntr and the Univ of Kansas Hosp, Kansas City, KS; Univ of Kansas Med Cntr, Kansas City, KS; Univ of Kansas Med Cntr and the Univ of Kansas Hosp, Kansas City, KS
Introduction: Vitamin D deficiency is associated with hypertension, peripheral vascular disease, diabetes mellitus, metabolic syndrome, coronary artery disease, and heart failure. We studied the association of vitamin D deficiency with cardiovascular morbidity and mortality as well as the impact of its supplementation on survival.
Methods: Serum vitamin D measurements were obtained from 1/1/2004 to 10/8/2009 for 10,899 patients and classified as normal (?30ng/ml) or deficient (<30ng/ml). The two patient groups were compared by baseline demographic, physiologic and disease state variables. Outcomes were analyzed with multivariable logistic regression, survival, and cox proportional hazards models.
Results: The mean age was 58 ± 15 years; 29% were male. The mean vitamin D level was 24 ± 14 ng/ml. 3294 (30%) of subjects were classified as normal and 7665 (70%) as deficient. Vitamin D deficiency was found to be associated with several cardiovascular disease states including
- hypertension (OR 1.40, CI 1.285–1.536),
- coronary artery disease (OR 1.16, CI 1.012–1.334) and
- cardiomyopathy (OR 1.29, CI 1.019–1.633); as well as
- diabetes (OR 2.31, CI 2.018–2.633) and
- death (OR 2.95, CI 2.135–4.073) (all P's <.05).
Logistic regression analysis found vitamin D deficiency to be a strong independent
- predictor of death (OR 2.64, CI 1.901–3.662, P < .0001).
Vitamin D replacement was associated with substantial survival benefit (OR for death 0.39, CI 0.277–0.534, P < .0001) and was particularly beneficial in vitamin D deficient patients. This benefit was independent of other cardioprotective factors such as aspirin or statin use.
Conclusions: Vitamin D deficiency is a significant risk factor for several cardiovascular disease states and is a significant independent predictor of reduced survival. Vitamin D supplementation is associated with greater survival benefit in deficient patients.
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