Tuesday, April 22, 2014. In an article published online on April 10, 2014 in the journal Perfusion, researchers from Iran's University of Medical Sciences report a benefit for vitamin D3 given to patients with cardiac syndrome X, also known as stable primary microvascular angina. The syndrome includes stable angina and findings compatible with myocardial ischemia, with normal or near normal coronary arteries as indicated by angiography and the absence of other specific cardiac diseases.
The study included 19 cardiac syndrome X patients given 300,000 units vitamin D by injection every other week for five weeks. Drugs prescribed for angina were discontinued one week prior to enrollment and during follow-up. Treadmill tests were conducted before treatment and at two months.
At the end of the treatment period, serum vitamin D levels had risen significantly in comparison with pretreatment values, while the number of daily chest pain episodes declined. Exercise duration and maximum work capacity increased following treatment with vitamin D, accompanied by a reduction in maximal ST-segment depression.
"To our knowledge, this study is the first to investigate the impact of vitamin D replacement therapy on patients with cardiac syndrome X," authors A. Andishmand and associates announce. "The present study shows that short-term therapy with vitamin D improves exercise capacity, the threshold of ischemia and the daily life symptoms of patients with cardiac syndrome X."
The authors note that low serum 25-hydroxyvitamn D levels are associated with increased lipid peroxidation and that supplementation with the vitamin has been found to benefit endothelial function. "Our findings suggest that vitamin D replacement therapy could provide a novel way of reducing angina symptoms and exercise capacity in patients with cardiac syndrome X," they conclude. "Further research is needed to test the reproducibility of these findings and define the optimum dose and the physiological effects of this new treatment on endothelial function."
A review and meta-analysis published on April 1, 2014 in the British Medical Journal adds more evidence to an association between a higher serum level of vitamin D and a lower risk of death from any cause over follow-up periods ranging from 0.3 to 29 years. The international team of researchers also uncovered a reduction in the risk of premature death in association with the use of vitamin D3 supplements.
Rajiv Chowdhury and colleagues selected 73 observational cohort studies that reported serum 25-hydroxyvitamin D levels and the cause of deaths that occurred among 849,412 men and women over follow-up. The analysis uncovered a 35% higher risk of death from cardiovascular disease or from any cause over follow-up among those whose vitamin D levels were in the lowest one-third of subjects in comparison with those whose levels were among the highest third. For non-vascular, non-cancer deaths, the risk was 30% higher and for cancer deaths, the risk was 14% higher among those in the lowest one-third of serum vitamin D.
Analysis of 22 randomized controlled trials of vitamin D supplements, involving a total of 30,716 participants, revealed an 11% lower risk of dying over three to seven years of follow-up among those who received vitamin D3 in comparison with a placebo or no treatment. As possible mechanisms for vitamin D in the prevention of premature mortality, the authors list a range of biological responses activated by vitamin D, involvement of the vitamin in gene regulation, association with increased white blood cell telomere length, and a relationship between low levels of vitamin D with suboptimal lifestyle and socioeconomic circumstances.
They recommend further investigations to establish optimal vitamin D3 dose and duration.
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