Relation of Vitamin D Deficiency to Cardiovascular Risk Factors, Disease Status, and Incident Events in a General Healthcare Population

American Journal of Cardiology, Volume 106, Issue 7 , Pages 963-968, 1 October 2010

• Jeffrey L. Anderson, MD
  • Cardiovascular Department, Intermountain Medical Center, Murray, Utah
  • Division of Cardiology, University of Utah School of Medicine, Salt Lake City, Utah
  • Corresponding Author InformationCorresponding author: Tel: (801) 507-4757; fax: (801) 507-4789
• Heidi T. May, PhD, MSPH
  • Cardiovascular Department, Intermountain Medical Center, Murray, Utah
• Benjamin D. Horne, PhD, MPH
  • Cardiovascular Department, Intermountain Medical Center, Murray, Utah
  • Division of Genetic Epidemiology, University of Utah School of Medicine, Salt Lake City, Utah
• Tami L. Bair, BS
  • Cardiovascular Department, Intermountain Medical Center, Murray, Utah
• Nathaniel L. Hall, MD
  • Cardiovascular Department, Intermountain Medical Center, Murray, Utah
  • Division of Cardiology, University of Utah School of Medicine, Salt Lake City, Utah
• John F. Carlquist, PhD
  • Cardiovascular Department, Intermountain Medical Center, Murray, Utah
  • Division of Cardiology, University of Utah School of Medicine, Salt Lake City, Utah
• Donald L. Lappé, MD
  • Cardiovascular Department, Intermountain Medical Center, Murray, Utah
• Joseph B. Muhlestein, MD
  • Cardiovascular Department, Intermountain Medical Center, Murray, Utah
  • Division of Cardiology, University of Utah School of Medicine, Salt Lake City, Utah

Intermountain Heart Collaborative (IHC) Study Group
Received 17 March 2010; accepted 12 May 2010. published online 13 August 2010.

Vitamin D recently has been proposed to play an important role in a broad range of organ functions, including cardiovascular (CV) health; however, the CV evidence-base is limited. We prospectively analyzed a large electronic medical records database to determine the prevalence of vitamin D deficiency and the relation of vitamin D levels to prevalent and incident CV risk factors and diseases, including mortality.

The database contained 41,504 patient records with at least one measured vitamin D level.

The prevalence of vitamin D deficiency (?30 ng/ml) was 63.6%, with only minor differences by gender or age.

Vitamin D deficiency was associated with highly significant (p <0.0001) increases in the prevalence of diabetes, hypertension, hyperlipidemia, and peripheral vascular disease. Also, those without risk factors but with severe deficiency had an increased likelihood of developing diabetes, hypertension, and hyperlipidemia.

The vitamin D levels were also highly associated with coronary artery disease, myocardial infarction, heart failure, and stroke (all p <0.0001),
as well as with incident death, heart failure, coronary artery disease/myocardial infarction (all p <0.0001),
stroke (p = 0.003), and their composite (p <0.0001).

In conclusion, we have confirmed a high prevalence of vitamin D deficiency in the general healthcare population and an association between vitamin D levels and prevalent and incident CV risk factors and outcomes. These observations lend strong support to the hypothesis that vitamin D might play a primary role in CV risk factors and disease. Given the ease of vitamin D measurement and replacement, prospective studies of vitamin D supplementation to prevent and treat CV disease are urgently needed.

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