Rainer Katharine W, Earle William, Michos Erin D, Miller Edgar R, Wanigatunga Amal A, Rebuck Heather, Christensen Robert, Schrack Jennifer A, Mitchell Christine M, Kalyani Rita R, Appel Lawrence J, Juraschek Stephen P
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Am J Prev Cardiol. 2024 Sep 26;20:100871. doi: 10.1016/j.ajpc.2024.100871. eCollection 2024 Dec.
OBJECTIVES: In observational studies, older adults with low serum vitamin D levels are at higher risk of cardiovascular disease (CVD), but randomized trials have failed to demonstrate reduction in CVD risk from vitamin D supplementation, possibly because the doses of vitamin D supplements tested were too low. Our objective was to determine if higher doses of vitamin D supplementation reduce high-sensitivity cardiac troponin (hs-cTnI) and N-terminal pro-b-type natriuretic peptide (NT-proBNP), markers of subclinical CVD. METHODS: The Study to Understand Fall Reduction and Vitamin D in You (STURDY) was a double-blind, randomized, response-adaptive trial that tested the effects of 4 doses of vitamin D3 supplementation (200, 1000, 2000, 4000 IU/day) on fall risk among older adults with low serum 25-hydroxyvitamin D concentrations (10-29 ng/mL). Hs-cTnI and NT-proBNP levels were measured at baseline, 3-, 12-, and 24-month follow-up visits. For this ancillary study, we used data from the original trial and compared participants by treatment group: low-dose (200 IU/day) or high-dose (1000+ IU/day). The effects of vitamin D dose on biomarkers were assessed via mixed effects tobit models. RESULTS: Among 688 participants (mean age of 76.5) hs-cTnI increased in both the low- and high-dose groups by 5.2 % and 7.0 %, respectively; likewise, NT-proBNP increased by 11.3 % and 9.3 %, respectively. Compared to the low-dose, high-dose vitamin D supplementation did not affect hs-cTnI (1.6 %-difference; 95 % CI: -5.3, 8.9) or NT-proBNP (-1.8 %-difference; 95 % CI: -9.3, 6.3). CONCLUSIONS: Compared to low-dose vitamin D supplementation, doses ≥1,000 IU/ day did not affect markers of subclinical CVD in older adults with low serum vitamin D levels.
Am J Prev Cardiol. 2024-9-26
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