Hypovitaminosis D and cardiovascular outcomes: A systematic review and meta-analysis

Vikash Jaiswal; Angela Ishak; Song Peng Ang; Nishan Babu Pokhrel; Nishat Shama; Kriti Lnu; Jeffy Susan Varghese; Tatyana Storozhenko; Jia Ee Chia; Sidra Naz; Prachi Sharma; Akash Jaiswal

doi:10.1016/j.ijcha.2022.101019

Hypovitaminosis D and cardiovascular outcomes: A systematic review and meta-analysis

Int J Cardiol Heart Vasc. 2022 Apr 11:40:101019. doi: 10.1016/j.ijcha.2022.101019. eCollection 2022 Jun.

Authors

Affiliations

¹ AMA School of Medicine, Makati, Philippines.
² European University Cyprus, School of Medicine, Nicosia, Cyprus.
³ School of Medicine, International Medical University, Kuala Lumpur, Malaysia.
⁴ Tribhuvan University Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
⁵ Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh.
⁶ Department of Internal Medicine, UPMC Harrisburg, PA, USA.
⁷ Department of Cardiology, St. John's Medical College, Bangalore, India.
⁸ Government Institution "L.T. Malaya Therapy National Institute NAMSU", Kharkiv, Ukraine.
⁹ BIDMC, Harvard Medical School, USA.
¹⁰ Department of Cardiology, King George's Medical University, Lucknow, India.
¹¹ Department of Geriatric Medicine, All India Institute of Medical Science, New Delhi, India.

Abstract

Background: The relation between blood vitamin D levels and the risk of cardiovascular outcomes is debatable. To our knowledge this is the first comparative meta-analysis of more than 100,000 patients' data with the aim to inspect the relevance of low vitamin D levels with adverse cardiovascular events.

Methods: Online databases including PubMed, Embase and Cochrane Central were queried to compare the cardiovascular outcomes among hypovitaminosis D (HVD) and control group. The outcomes assessed included differences in major adverse cardiovascular events (MACE), mortality, myocardial infarction, and heart failure. Unadjusted odds ratios (OR) were calculated using a random-effect model with a 95% confidence interval (CI) and P less than 0.05 as a statistical significance.

Results: A total of 8 studies including 426,039 patients were included in this analysis. HVD group was associated with a higher incidence of MACE (OR 1.92, 95% CI 1.24 to 2.98, p = 0.003), while there was no significant association of HVD and all-cause mortality (OR 1.77, 95% CI 0.75 to 4.17, p = 0.19), risk of myocardial infarction (OR 0.69, 95% CI 0.39 to 1.24, p = 0.22), and heart failure (OR 1.20, 95% CI 0.34 to 4.25, p = 0.78).

Conclusions: This meta-analysis suggested that low blood levels of vitamin D are associated with MACE, but no such difference in all-cause mortality, myocardial infarction or heart failure was observed. Appropriate supplementation of vitamin D in selected populations might be cardioprotective in nature and warrants extensive trials.

Keywords: ACM, All Cause Mortality; Cardiovascular disease; HF, Heart Failure; HVD, Hypovitaminosis D; Hypovitaminosis; MACE, Major adverse cardiovascular events; MI, Myocardial Infarction; Mortality; Vitamin D.