Archief Roodbont

Moderate-to-high dose vitamin D may reduce CVD risk

19 March 2010

MedWire News: A systematic review published in the Annals of Internal Medicine suggests that vitamin D, but not calcium, supplements may prevent cardiovascular disease (CVD).

Another review in the same journal suggests healthy people with the lowest versus highest active vitamin D levels may be at increased risk for hypertension and possibly CVD.

But the US researchers, all in Boston, Massachusetts, caution that no completed trials have specifically tested the effect of vitamin D supplements on CVD, and those so far conducted show no consistent impact on blood pressure or glycemic outcomes.

Lu Wang (Brigham and Women’s Hospital) and colleagues studied 17 prospective studies and randomized trials.

Six prospective cohorts revealed consistent inverse associations between vitamin D supplementation and CVD mortality, although five involved dialysis patients and not healthy adults.

Four prospective studies of initially healthy people found no impact of calcium supplements on CVD incidence.

Secondary analyses in eight randomized trials showed a statistically insignificant reduction in CVD risk with vitamin D supplements at moderate-to-high doses of approximately 1000 IU/day.

In the second study, researchers reviewed 13 prospective observational studies and 18 trials. Ethan Balk (Tufts Medical Center) and colleagues identified a lower incident diabetes risk with the highest versus lowest blood vitamin D status in three of six analyses.

Lower blood 25-hydroxyvitamin D concentrations were associated with incident hypertension (relative risk=1.8) in a meta-analysis of three cohorts, and incident CVD in five of seven analyses.

Eliseo Guallar, Edgar Miller III (Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland) Jose Ordovas (Tufts University) and Saverio Stranges (University of Warwick, UK) comment on the studies in an accompanying editorial.

They say: “Despite the promise of disease prevention suggested by available studies, we believe that the evidence for widespread use of high-dose vitamin D supplementation in the general population remains insufficient.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Ann Intern Med 2010; 152: 307–314, 315–323