Document Detail

Vitamin D deficiency and cardiovascular events in patients with coronary heart disease: data from the Heart and Soul Study.
MedLine Citation:
PMID:  24699783     Owner:  NLM     Status:  MEDLINE    
A growing body of evidence supports an association between vitamin D and cardiovascular disease. However, the mechanisms underlying this association are unknown. From 2000 to 2002, we identified 946 participants with stable cardiovascular disease in San Francisco, California, and followed them prospectively for cardiovascular events (heart failure, myocardial infarction, stroke, or cardiovascular death). We then examined the extent to which the association was attenuated by adjustment for poor health behaviors, comorbid health conditions, and potential biological mediators. During a median follow-up period of 8.0 years (through August 24, 2012), 323 subjects (34.1%) experienced a cardiovascular event. Following adjustment for sociodemographic factors, season of blood measurement, health behaviors, and comorbid conditions, 25-hydroxyvitamin D levels under 20 ng/mL remained independently associated with cardiovascular events (hazard ratio = 1.30, 95% confidence interval: 1.01, 1.67). However, after further adjustment for potential biological mediators, the independent association was no longer present (hazard ratio = 1.11, 95% confidence interval: 0.85, 1.44). Parathyroid hormone, a potentially modifiable biological factor downstream from 25-hydroxyvitamin D, was responsible for the majority of this attenuation. These findings highlight the need for randomized controlled trials to determine whether vitamin D supplementation in persons with deficiency could be beneficial for the primary or secondary prevention of cardiovascular events.
Christine C Welles; Mary A Whooley; S Ananth Karumanchi; Tammy Hod; Ravi Thadhani; Anders H Berg; Joachim H Ix; Kenneth J Mukamal
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Publication Detail:
Type:  Journal Article; Observational Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2014-04-03
Journal Detail:
Title:  American journal of epidemiology     Volume:  179     ISSN:  1476-6256     ISO Abbreviation:  Am. J. Epidemiol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-05-28     Completed Date:  2014-07-14     Revised Date:  2014-11-06    
Medline Journal Info:
Nlm Unique ID:  7910653     Medline TA:  Am J Epidemiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1279-87     Citation Subset:  IM    
Copyright Information:
© The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail:
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MeSH Terms
Biological Markers / blood
Coronary Disease / complications*
Follow-Up Studies
Heart Failure / etiology*
Middle Aged
Myocardial Infarction / etiology*
Proportional Hazards Models
Prospective Studies
Risk Factors
Stroke / etiology*
Vitamin D / analogs & derivatives,  blood
Vitamin D Deficiency / blood,  complications*,  diagnosis
Grant Support
DK094486/DK/NIDDK NIH HHS; DK094872/DK/NIDDK NIH HHS; //Howard Hughes Medical Institute
Reg. No./Substance:
0/Biological Markers; 1406-16-2/Vitamin D; 64719-49-9/25-hydroxyvitamin D
Comment In:
Am J Epidemiol. 2014 Oct 1;180(7):757-8   [PMID:  25150268 ]
Am J Epidemiol. 2014 Jun 1;179(11):1288-90   [PMID:  24699787 ]
Am J Epidemiol. 2014 Oct 1;180(7):758   [PMID:  25150267 ]
Erratum In:
Am J Epidemiol. 2014 Oct 1;180(7):762

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