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Low vitamin D level may increase risk for heart failure hospitalization
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Adults with a low serum 25-hydroxyvitamin D concentration are more likely to be admitted to the hospital with heart failure and spend more days in the hospital compared with those who have normal vitamin D concentrations, study data show.
Simona Costanzo, MSc, PhD, of the laboratory of molecular and nutritional epidemiology at IRCCS Neuromed in Pozzilli, Italy, and colleagues analyzed data from 19,092 residents of the Molise region of Italy aged at least 35 years and without previous heart failure (HF), randomly enrolled in the Moli-sani study between March 2005 and April 2010 through city hall registries (49% men). Participants provided blood samples to measure serum 25-(OH)D, high-sensitivity C-reactive protein and subclinical inflammation; dietary calcium and vitamin D were assessed via food frequency questionnaires. Vitamin D levels were defined as normal ( 30 ng/mL; 12.2%), insufficient (10-29 ng/mL; 79.6%) or deficient ( 10 ng/mL; 8.2%). Researchers followed the cohort for a median of 6.2 years for admission to the hospital for HF, using linked regional hospital discharge data.
During follow-up, researchers observed 562 first admissions to the hospital for HF (crude rate, 2.9%). Those with an HF event were more frequently men, older and more obese and had previous cardiovascular disease and a higher prevalence of hypertension, diabetes and metabolic syndrome vs. those without HF.
Across vitamin D levels, the incidence of HF was 1.6%, 2.9% and 5.3% in those with normal, insufficient and deficient levels of vitamin D, respectively. After adjustment for multiple factors, including high-sensitivity C-reactive protein concentration, the risk for incident HF remained higher among those with vitamin D insufficiency (HR = 1.14; 95% CI, 0.81-1.61) and vitamin D deficiency (HR = 1.61; 95% CI, 1.06-2.46) compared with those with normal vitamin D levels.
During follow-up, there were 797 hospital admissions for HF with a mean length of stay of 10.3 days. Participants with vitamin D deficiency accumulated 54% more total hospital days vs. those with normal vitamin D levels (95% CI, 39-71), according to researchers.
“Our observational findings cannot prove if low levels of serum vitamin D might play a causal role in the development of HF,” the researchers wrote. “Additionally, in light of the fact that, until now, prospective trials on vitamin D therapy in HF patients have shown inconclusive results, further focused studies on primary HF prevention are required to test this hypothesis.” – by Regina Schaffer
Disclosures: The authors report no relevant financial disclosures.
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