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

• Published in: International journal of cardiology. Heart & vasculature Vol. 40; p. 101019
• Main Authors: Jaiswal, Vikash, Ishak, Angela, Peng Ang, Song, Babu Pokhrel, Nishan, Shama, Nishat, Lnu, Kriti, Susan Varghese, Jeffy, Storozhenko, Tatyana, Ee Chia, Jia, Naz, Sidra, Sharma, Prachi, Jaiswal, Akash
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.06.2022; Elsevier
• Subjects: Cardiovascular disease; Hypovitaminosis; Mortality; Original Paper; Vitamin D; Vitamin D; MACE; Mortality; HVD; Hypovitaminosis; Cardiovascular disease; ACM; MI; HF; ACM, All Cause Mortality; MI, Myocardial Infarction; MACE, Major adverse cardiovascular events; HVD, Hypovitaminosis D; HF, Heart Failure
• ISSN: 2352-9067; 2352-9067
• DOI: 10.1016/j.ijcha.2022.101019

•Vitamin D deficiency can not only affect bones but have association with cardiovascular effects.•The likelihood of unfavorable cardiovascular outcomes, especially major adverse cardiovascular event (MACE), new MI, and all-cause mortality among deficient vitamin D patient is poorly understood.•This is a first and most comprehensive meta-analysis with the largest sample size thus far comparing vitamin D levels in terms of cardiovascular outcomes.•High risk patients need to monitor vitamins level and implement vitamins supplementation to avoid adverse outcomes especially elder females. 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. 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. 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). 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.