Lower serum levels of vitamin D associated with increased CAD severity
Tuesday, April 15, 2014. A presentation at the American College of Cardiology's 63rd Annual Scientific Session held in Washington, DC reveals the finding of a correlation between declining vitamin D levels and increasing coronary artery disease (CAD) severity in a study of Italian men and women.
The study included 1,484 subjects undergoing coronary angiography to evaluate arterial blood flow, which is impaired among those with atherosclerosis. Diameter reduction of 50% or more in at least one coronary artery was considered diagnostic of coronary artery disease. Deficient serum vitamin D levels, defined as 20 nanograms per milliliter (ng/mL) or less, were uncovered in 70.4% of the subjects, among whom some were severely deficient with values of less than 10 ng/mL.
The presence of coronary artery disease was 32% higher among those with vitamin D deficiency, and nearly twice as high among subjects with severely deficient levels compared with those whose levels were normal. Among those with deficiency the risk of severe coronary artery disease affecting several vessels was 20% higher than that experienced by nondeficient subjects.
The study is the largest study of its kind to date to assess the relationship between vitamin D levels and CAD severity. "Present results suggest vitamin D deficiency to be the cause rather than the consequence of atherosclerosis," observed researcher Monica Verdoia, MD, who is a cardiologist at the Department of Cardiology, Ospedale Maggiore della Carità, Eastern Piedmont University in Novara, Italy. "Strategies to raise endogenous vitamin D should probably be advised in the prevention of cardiovascular disease."
Dr Verdoia and her colleagues plan to initiate clinical trials to test the effects of treatment of vitamin D deficiency and investigate the vitamin's protective mechanisms in cardiovascular disease.
An article scheduled to be published in the August 2014 issue of Menopause, the journal of The North American Menopause Society, will report findings gleaned from the Women's Health Initiative CaD trial of improved lipid levels among participants supplemented with calcium and vitamin D.
North American Menopause Society Board of Trustees member Peter F. Schnatz, DO, NCMP, and his colleagues compared serum lipid levels of over 600 participants who received a placebo or 1,000 milligrams calcium plus 400 international units (IU) vitamin D3 over the course of the trial. In addition to being twice as likely to have vitamin D levels of 30 nanograms per milliliter (ng/mL) or more, women who received calcium and vitamin D had levels of low-density lipoprotein (LDL) that averaged 4 to 5 milligrams per deciliter (mg/dL) lower than those who received a placebo. Subjects who received calcium plus vitamin D also had greater levels of beneficial high-density lipoprotein (HDL) cholesterol levels than the placebo group. Older age, having a low intake of the nutrients prior to the study, not smoking and consuming less alcohol in comparison with the remainder of the participants were associated with a greater increase in serum vitamin D.
Furthermore, among those whose vitamin D levels were 15 ng/mL or higher, calcium and vitamin D supplementation was associated with lower levels of triglycerides.
"The results of this study should inspire even more women to be conscientious about their calcium and vitamin D intake—a simple and safe way to improve health," noted North American Menopause Society Executive Director Margery Gass, MD. "One action can lead to multiple benefits!"
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