Cardiovascular Morbidity

Vitamin D plus calcium (CaD) supplementation did not significantly reduce heart failure (HF) incidence in the overall cohort, however, it was beneficial among postmenopausal women without major HF precursors while of little value in high-risk subgroups. Vitamin D supplementation may be an inexpensive intervention to reduce incidence.  Analyses were restricted to 35 983 (of original 36 282) women aged 50 to 79 years old in the Women’s Health Initiative randomized trial of CaD supplementation who were randomized 1:1 in a double-blinded fashion to receive 1000 mg/d of calcium plus 400 IU/d of vitamin D3 or placebo. Overall, 744 adjudicated incident HF cases (intervention, 363; control, 381) occurred during a median follow-up of 7.1 (interquartile range, 1.6) years. CaD supplementation, compared with placebo, was not associated with reduced HF risk in the overall population, hazard ratio, 0.95; P=0.46. However, CaD supplementation had differential effects (P interaction=0.005) in subgroups stratified by baseline risk status of HF defined by the presence (high risk=17 449) or absence (low risk=18 534) of pre-existing HF precursors including coronary heart diseases, diabetes mellitus, or hypertension: 37% (hazard ratio, 0.63 [95% confidence interval, 0.46-0.87]) lower risk of HF in the low-risk versus hazard ratio, 1.06; P=0.51, in the high-risk subgroups.  See Macarius M. Donneyong et al. (2015).

A large-scale (n=242), 12-year epidemiological study compared baseline circulating DHEA-S serum levels and mortality in men aged 50 to 79 years at the start of the study.  DHEA-S levels decrease with age and are significantly lower in men with a history of heart disease.  An increase in serum DHEA-S level of 100 µg per deciliter was associated with a 36% reduction in mortality for any cause (P<0.05) and a 48% reduction in mortality from cardiovascular disease (P<0.05), after adjusting for age, systolic blood pressure, serum cholesterol level, obesity, fasting plasma glucose level, cigarette smoking status and personal history of heart diease.  Elizabeth Barrett-Connor et al., A Prospective Study of Dehydroepiandrosterone Sulfate, Mortality and Cardiovascular Disease, New Eng J Med v. 315 pp. 1519-24 (1986):