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Vitamin D Deficiency Increases Risk of Heart Failure

11/21/2017 2:47:56 PM
Heart failure most often begins with diastolic dysfunction, marked by increased rigidity of the myocardium and slower ventricular relaxation. Myocardial rigidity is the result of changes to the extracellular matrix of the myocardium, with increased collagen, increased fibronectin, and reduced elastin—mediated by activity of matrix metalloproteinases (MMPs). Vitamin D has been shown to stimulate tissue inhibitors of MMPs as well as suppress inflammatory pathways, preventing excessive degradation of the extracellular matrix.
To investigate whether vitamin D deficiency might be associated with an increased risk of heart failure, researchers Porto et al. conducted a cross-sectional epidemiological study. The study included data from the medical records of 137 patients (aged 60 years or older) seen at one of 2 cardiac clinics in Brazil. Vitamin D deficiency was defined as serum concentration of 25(OH)D <30ng/mL. Risk of heart failure was calculated by the Health Aging and Body Composition (ABC) Scale, which is a validated model that relies on clinical, laboratory, and demographic data to predict heart failure risk.
Among the population sample, 48% were overweight, 31% were obese, 94% had dyslipidemia, 91% had hypertension, 35% had coronary artery disease, 28% had cardiac arrhythmia, and 65% had vitamin D deficiency. According to the ABC Scale, more than half of all participants were at risk of heart failure. Of the participants with vitamin D deficiency, 79% were at risk of heart failure.
The risk of heart failure was significantly associated with vitamin D deficiency (OR=12.9; 95% CI, 4.23-35.16; p<.001). In multivariate analysis, the risk of heart failure was also significantly associated with being male (OR=15.32), obesity (OR=4.17), and cardiac arrhythmia (OR=3.69).
Previously established risk factors for heart failure include advanced age, being male, diabetes, and hypertension. The results of this epidemiological study suggest that vitamin D deficiency (25[OH]D<30ng/mL) is also associated with an increased risk of heart failure in the elderly.
Reference: Porto CM, Silva VL, da Luz JSB, Filho BM, da Silveira VM. Association between vitamin D deficiency and heart failure risk in the elderly. ESC Heart Fail. 2017