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Lower levels of vitamin D, higher rates of death Association of Serum 25-Hydroxyvitamin D Concentrations With All-Cause and Cause-Specific Mortality Among Adult Patients With Existing Cardiovascular Disease https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496747/ Observational study, non-interventional Background Vitamin D, lower levels, common in patients with cardiovascular disease (CVD) Study of patients with existing CVD Prospectively examine the associations of serum 25-hydroxyvitamin D [25(OH)D] concentrations with, All-cause mortality and, cause-specific mortality Methods N = 37,079 patients with CVD from the UK Biobank study From a prospective cohort of half a million, aged 40–69 years https://www.ukbiobank.ac.uk CVD Coronary heart disease Atrial fibrillation Heart failure Stroke Results Among 37,079 patients with CVD at baseline, 57.5% were vitamin D deficient Deficient, 25[OH]D less than 50 nmol/L (less than 20ng/ml) Median follow-up of 11.7 years Deaths that occurred = 6,319 total 2,161 deaths from CVD 2,230 deaths from cancer 623 deaths from respiratory disease 1,305 other-cause deaths Non-linear inverse associations For all-cause mortality Cancer mortality Respiratory disease mortality Other-cause mortality That is deaths went up as vitamin D levels went down (P-non-linearity less than 0.01) Approximately linear inverse associations for CVD That is deaths went up as vitamin D levels went down (P-non-linearity = 0.074) Among CVD patients with vitamin D deficiency For every 10 nmol/L increment in serum 25(OH)D concentrations, There was an associated 12% reduced risk for all-cause mortality There was an associated 9% reduced risk for CVD mortality. In patients with vitamin D deficiency Per 10 nmol/L increase in serum 25(OH)D levels, was associated with a lower risk of mortality from (aHR]; 95% CI) All-cause 0.88 CVD 0.91 Cancer 0.90 Respiratory diseases 0.81 Other causes 0.81 Multivariable Cox regression models Age, sex, alcohol, BMI, GFR, education, ethnicity, household income, smoking status, healthy diet score, diabetes (and meds), HbA1c, duration of CVD, blood pressure (and meds), lipid profile (and meds), triglycerides, cholesterol Conclusion Among patients with existing CVD, increasing levels in serum 25(OH)D, were independently associated with a decreased risk of all-cause and cause-specific mortality These findings suggest that elevated serum 25(OH)D concentration benefits CVD patients with vitamin D deficiency. Therefore Patients with vitamin D deficiency may benefit more from an increase in serum levels, than those with CVD and serum 25(OH)D levels of less than 50 nmol/L (less than 20ng/ml) Our findings provided novel clues awaiting further validation in clinical trials.

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