Abstract 1147: Vitamin D Deficiency is Strongly Associated With Incident Death and Cardiovascular Disease in a General Healthcare Population
BACKGROUND: Vitamin D deficiency has long been associated with musculoskeletal disorders. However, recently it has also been implicated in various other heath problems, including hypertension, diabetes mellitus and renal disease. How this translates to future cardiovascular risk among the general population remains undefined.
METHODS: Patients (N=27,686) within an integrated healthcare system, ≥50 years of age with no prior history of a cardiovascular diagnosis, in which a baseline 25[OH] vitamin D (vit D) level was obtained were studied. Vit D was stratified into 3 categories: Normal [N]: >30 ng/ml (n=10,111), Low [L]: 15–30 ng/ml (n=13,057), and Very low [VL]: ≤15 ng/ml (n=4,518). Multivariable Cox regression analysis was utilized to determine associations of baseline vit D to an incident death (D) or an incident ICD9 CVD diagnosis of coronary artery disease (CAD), heart failure (HF), cerebrovascular accident (CVA) or atrial fibrillation (AF).
RESULTS: Age averaged 66.6±10.8 years and 25.0% were male. Average length of follow-up was 1.3±1.2 years. Over-all 1193 (4.3%) died and 2614 (9.4%), 1742 (6.3%), 314 (1.1%) and 1505 (5.4%) patients developed CAD, HF, CVA and AF respectively. Adjusted hazard ratios (HR) are shown on the table⇓. Highly significant increases in death and every other cardiovascular diagnosis except atrial fibrillation were associated with VL vit D.
CONCLUSION: Among patients ≥50 years of age in a general medical population followed for less than 2 years, moderate to severe levels of vitamin D deficiency are strongly associated with death and the incident development of CAD, HF or CVA but not AF. The clinical implication of these findings, including vit D supplementation, deserves further study.