Heart failure, risk increases in the elderly with vitamin D deficiency
The risk of heart failure is 12 times higher in the elderly with vitamin D deficiency than in those with adequate concentrations. Poor levels of the vitamin are, in fact, a higher risk factor for heart failure than obesity or arrhythmia. Supplementation with vitamin D could, therefore, in the future be an effective and cost-effective strategy for the prevention of some cardiac disorders.
This was discovered by researchers at the University of Pernambuco, Recife, Brazil. The results of the research were published in the peer-reviewed journal ESC Heart Failure.
Heart failure is a widespread problem in old age
Heart failure, or heart failure, is a condition in which the heart is unable to pump sufficient blood to all tissues and organs of the body due to a weakening of myocardial tissue. The consequences and symptoms of this condition are diverse and include shortness of breath on physical exertion, difficulty breathing in the supine position, coughing, a swollen abdomen, and confusion. Heart failure is very common and is a major public health problem, being one of the leading causes of hospitalization among the elderly. As age progresses, in fact, the myocardium undergoes alterations in its composition and thus function. Among the risk factors associated with heart failure are:
- advanced age
- the male gender
- diabetes mellitus
- acute myocardial infarction
- hypertension
There is strong evidence in the scientific literature regarding the association between vitamin D deficiency and the risk of heart failure and the functions of vitamin D in cardiovascular metabolism. For example, the prospective study "LURIC," conducted in 3299 patients with cardiovascular disease, found a high prevalence of myocardial dysfunction associated with severe vitamin D deficiency.
Recent research conducted by researchers at Leeds Teaching Hospitals on 163 patients with heart failure has shown that vitamin D supplements can improve the heart's ability to pump blood throughout the body. As is well known, in addition to getting vitamin D from certain foods, the human body can produce it through a series of reactions that begin with the action of sunlight on the skin. Therefore, in some countries, especially during the winter months, vitamin D deficiency is more common. This condition is very common in those over the age of 60.
Indeed, elderly people are unlikely to eat a proper diet, usually have poor bowel function and limited exposure to daylight. For these reasons, they often do not reach the minimum recommended level (30 ng/mL) of 25-hydroxyvitamin D, the inactive form of vitamin D that is measured in the blood.
Heart failure: more likely when there is vitamin D deficiency
According to the new study, which related heart failure in Brazilian elderly to several risk factors, the likelihood of heart failure affects more than half of the selected elderly and is strongly associated with vitamin D deficiency. In detail, the results revealed that the risk of heart failure was 12 times higher in the elderly with low vitamin D in the blood compared with those with adequate status, and that this new factor increased the likelihood of the heart disorder more than obesity or arrhythmia. According to the researchers who conducted the study, however, further studies are needed to test a possible role of vitamin D supplements in preventing heart disease in the elderly. In any case, based on the evidence obtained, which is supported by a large body of other research, the high percentage of elderly individuals with vitamin D decrease and the consequences on the risk of heart failure suggest the need to establish recommendations on the dosage of the vitamin, which is necessary to keep the heart healthy.
The details of the study
Between August 2015 and February 2016, researchers collected clinical data from 137 elderly Brazilians undergoing routine cardiologic evaluations The threshold for vitamin D adequacy, measured as 25-hydroxyvitamin D, in this study was established as less than 30 nanograms per milliliter of blood. To analyze the association between deficiency of the vitamin and risk of heart failure, the researchers used specific statistical analyses.
Data collection showed that most of the elderly people involved were overweight or obese, with a high waist-to-hip ratio, and a high prevalence of dyslipidemia and hypertension. In addition, 91.2% of the subjects were hypertensive, 35% had coronary artery disease, and 27.7% had cardiac arrhythmia. As many as 62% of the subjects included in the study showed 25-hydroxyvitamin D deficiency, and among them, 78.7% had an increased risk of heart failure.
The results of the statistical analysis thus showed that among those who suffered from vitamin D deficiency, the likelihood of heart failure was 12.2 times higher than among those who had normal levels of the vitamin. Men were found to be more predisposed to heart failure, and the risk was also associated, albeit to a lesser extent than with 25-hydroxyvitamin D deficiency, with obesity and arrhythmia.
Vitamin D supplementation? The effects will be confirmed by further research.
Through their findings, the scientists found a high percentage of elderly people with 25-hydroxyvitamin D deficiency, and a strong association between this nutritional deficiency and increased risk of heart failure. The researchers could not determine whether or not vitamin D deficiency is the true cause of the condition. However, they suggested that a lower risk of heart failure might result from the vitamin's ability to suppress the inflammatory response, an important factor in the pathogenesis of heart failure. For these reasons, and considering the low cost of possible supplementation, the scientists who conducted the study hypothesized the possibility of preventing and treating some heart failure with vitamin D supplements, if future studies also confirm its efficacy.
Source: Magalhães Porto et al, "Association between vitamin D deficiency and heart failure risk in the elderly." ESC Heart Failure 2018 Feb; 5(1): 63-74.
