Vitamin D Deficiency and Heart Failure

August 30, 2018

Is there a link between vitamin D deficiency and mortality in patients with heart failure? A new study may have the answer.

Vitamin D Deficiency and Heart Failure. Patients with chronic heart failure (HF) are frequently deficient in vitamin D, but current data on the link between vitamin D deficiency and mortality in chronic HF is sparse and inconclusive. That is why authors of a new study sought to find out if there is indeed a connection. What were their findings? The results may just have you prescribing some time in the sun.

Low Vit D and HF: Cloudy Picture. While the EVITA study showed vitamin D supplementation did not improve mortality in HF¹ and the VINDICATE study showed vitamin D benefited LV structure and function in HF patients,² they did not have comparable populations. So, the authors of a new study sought to determine the link between vitamin D deficiency and mortality in patients with chronic HF.

Prospective Study Vit D Deficiency and Mortality in HF.³ Authors analyzed 1802 patients with stable HF who were seen at 4 HF clinics in northern England from June 2006 to July 2014. ECG, lab tests, vitamin D levels, eGFR, LVEF, and functional status were all evaluated and results were adjusted for demographics and HF variables.

24% Higher Risk of Mortality Vit D Deficiency vs Nondeficient. Authors found a 24% higher risk of mortality in vitamin D deficient vs nondeficient partcipants and with every 2.72 fold increase in vitamin D levels, there was a 14% lower risk in all-cause mortality.

Clinical Implications:

Vitamin D deficiency independently predicts mortality in HF patients on optimal medical and device therapy
Unclear whether vitamin D deficiency is a marker of chronic disease and whether supplementation may improve HF outcomes
Longer term RCTs are needed to evaluate vitamin D supplementation in people with HF on optimal therapy

Take Home Points:

Vitamin D deficiency is linked to a 24% increased risk of mortality in patients with chronic HF
Every 2.72 fold increase in vitamin D levels is linked to a 14% lower risk of all-cause mortality
Longer term RCTs are needed to evaluate vitamin D supplementation in people with chronic HF

References

References:

1. Zittermann A, Ernst JB, Prokop S, et al. Effect of vitamin D on all-cause mortality in heart failure (EVITA): a 3-year randomized clinical trial with 4000 IU vitamin D daily. Eur Heart J. 2017;38:2279-2286.

2. Witte KK, Byrom R, Gierula J, et al. Effects of vitamin D on cardiac function in patients with chronic HF: The VINDICATE study. J Am Coll Cardiol. 2016;67:2593-2603.

3. Cubbon RM, Lowry JE, Drozd M, et al. Vitamin D deficiency is an independent predictor of mortality in patients with chronic heart failure. Eur J Nutr. 2018.