Vitamin D deficiency linked to 62% increased risk for fatal Cardio Vascular Disease, 27% increased risk for Coronary Heart Disease

Medscape Medical News

Vitamin D Deficiency Linked to Fatal Cardio Vascular Disease

Miriam E. Tucker

December 23, 2013

HEIDELBERG, GERMANY — Vitamin D deficiency is much more strongly linked to fatal than nonfatal CV events, results of a large prospective study suggest ^[1].

“Although our results were able to confirm an approximately 27% increased total CV risk in subjects with vitamin D deficiency, they indicate that the risk is much stronger for (and possibly even confined to) fatal CVD events,” write the researchers, led by cofirst authors Drs Laura Perna and Ben Schottker, German Cancer Research Center (Heidelberg).

The findings were published in the December issue of the Journal of Clinical Endocrinology and Metabolism.

Previous observational and randomized trials linking serum 25-hydroxyvitamin D (25(OH)D) concentrations with increased CVD risk have typically used only a single vitamin D measurement and did not separately examine fatal and nonfatal outcomes, they note.

The current population-based cohort study enrolled 9949 adults aged 50 to 74 years recruited during regular health check-ups at primary-care practices in 2000 to 2002. There were more women than men (59% vs 41%); most participants (59%) had inadequate vitamin D levels (<50 nmol/L). Blood samples were collected at baseline, five, and eight years.

Mean follow-up was 9.2 years for mortality and 6.5 years for the end points of Cardio Vascular Disease,CVD, Coronary Heart Disease, CHD, and stroke. A total of 854 patients had a nonfatal CVD event, 176 had a fatal CVD event, 460 had a nonfatal CHD event, 79 had a fatal CHD event, 313 had a nonfatal stroke, and 41 had a fatal stroke.

Overall, the proportion of individuals who had no events was significantly lower among those with vitamin D deficiency. The association continued after adjustment for age, sex, and season of blood drawn, with hazard ratios ranging from 1.46 for total CVD to 1.58 for total stroke.

Even after adjustment for other potential confounders, including smoking and physical activity, vitamin D deficiency still conferred a significant 27% increased risk for total CVD, and a 62% increased risk for fatal CVD. However, there was no association between vitamin D deficiency and nonfatal CVD events.

Individuals with low vitamin D levels also had a significant 36% increased risk of total CHD and a nonsignificant 33% increased risk of total stroke.

A possible explanation for the stronger association between 25(OH)D and CVD mortality than nonfatal CVD end points is that low vitamin D levels could lead to more severe events and perhaps also reduce capacity to cope with the events. Alternatively, the association of 25(OH)D with mortality may be more strongly affected by confounders linking to both low vitamin D and poor health status, such as diabetes or chronic kidney disease, the authors suggest.

This study was funded by the State Ministry of Science, Research, and Arts of Baden–Württemberg; German Cancer Aid (project 108250), and CHANCES project, funded in the FP7 framework program of DG-RESEARCH, European Commission (grant 242244). The authors have disclosed no relevant financial relationships.

• References

Americans Have Little Faith In Scientists, Science Journalists: Poll

Posted: 12/21/2013 11:23 am EST

57% don't trust Science studies "only a little" or "not at all".

83% don't trust scientific journals to get the facts right in their stories about scientific studies.

78% of Americans think that information reported in scientific studies is often (34 percent) or sometimes (44 percent) influenced by political ideology

The HuffPost/YouGov poll was conducted Nov. 23-24 among 1,000 U.S. adults using a sample selected from YouGov's opt-in online panel to match the demographics and other characteristics of the adult U.S. population. Factors considered include age, race, gender, education, employment, income, marital status, number of children, voter registration, time and location of Internet access, interest in politics, religion and church attendance.
http://www.huffingtonpost.com/2013/12/21/faith-in-scientists_n_4481487.html

How much faith do Americans have in scientists and science journalists? Not a whole lot, a new survey finds.

In a new HuffPost/YouGov poll, only 36 percent of Americans reported having "a lot" of trust that information they get from scientists is accurate and reliable. Fifty-one percent said they trust that information only a little, and another 6 percent said they don't trust it at all.

Science journalists fared even worse in the poll. Only 12 percent of respondents said they had a lot of trust in journalists to get the facts right in their stories about scientific studies. Fifty-seven percent said they have a little bit of trust, while 26 percent said they don't trust journalists at all to accurately report on scientific studies.

What’s more, many Americans worry that the results of scientific studies are sometimes tainted by political ideology -- or by pressure from the studies’ corporate sponsors.

A whopping 78 percent of Americans think that information reported in scientific studies is often (34 percent) or sometimes (44 percent) influenced by political ideology, compared to only 18 percent who said that happens rarely (15 percent) or never (3 percent).

Similarly, 82 percent said that they think that scientific findings are often (43 percent) or sometimes (39 percent) influenced by the companies or organizations sponsoring them.

Republicans in the new poll were most likely to say that they have only a little bit of trust in scientists to give accurate and reliable information, and the most likely to say that they think scientific findings may be tainted by political ideology -- possibly reflecting distrust in scientists over topics such as evolution and climate change.

Related Story

Editor's note:These "studies" are actually meta-studies, meaning that they take a number of somewhat similar studies done by others in a defined period and lump them all together. For researchers, this is a great new way to get grants and other money without having to actually spend any money doing research. They still get to call it research though. They also get to massage the data of 30 studies with different parameters and reporting to make it all come out right.

“Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.”

This week, the Annals of Internal Medicine—one of the world’s leading medical journals—published three studies evaluating the benefits of vitamins and dietary supplements.

The first study determined whether healthy people who received daily multivitamins had a lesser incidence of cancer or heart disease and whether they lived longer. The study was quite large, involving about 400,000 adults. Study participants were randomly divided into two groups: One group received daily multivitamins; the other didn’t. The authors found no difference in any medical outcome.

The second study examined about 6,000 men older than 65 to see whether daily multivitamins improved cognitive performance or verbal memory. The group that received multivitamins was indistinguishable from the group that didn’t.

The third study examined about 1,700 men and women with a history of a heart attack to see whether multivitamins could prevent another cardiac episode. Patients were followed for about five years. The study was limited by a high dropout rate, but again, multivitamins did nothing to prevent heart attacks in those at highest risk.

In the editorial that accompanied these studies, the authors summarized the evidence. “Beta-carotene, Vitamin E, and possibly high doses of Vitamin A supplements are harmful,” they wrote. “Other antioxidants, folic acid, and B vitamins, and multivitamin and mineral supplements are ineffective for preventing mortality or morbidity due to major chronic diseases.” In other words, megavitamins (which contain quantities in excess of the Recommended Daily Amount, or RDA) were potentially harmful, and multivitamins (which contain at or around the RDA) were useless. The title of the editorial wasn’t subtle: “Enough Is Enough: Stop Wasting Money on Vitamin and Mineral Supplements.”

Readers Digest - Heart Disease Risk Factor #1: Nitric Oxide

Heart Disease Risk Factor #1: Nitric Oxide
The role of nitric oxide in cardiovascular health.

from Cut Your Cholesterol

The same chemical responsible for men’s erections (and, indirectly, for the success of Viagra) also plays a vital role in the health of your arteries, and thus your heart.

The chemical is nitric oxide (NO), which is primarily produced in the blood vessels’ endothelium, or lining. There it increases blood flow, prevents fatty deposits from sticking to blood vessel walls, keeps walls from getting too thick and stiff, and prevents the arteries from narrowing.

“The lining of the vessel is very important for cardiac health,” says John P. Cooke, M.D., Ph.D., head of Stanford University’s vascular unit and one of the first researchers to pinpoint the role of NO in cardiovascular health. “When the endothelium is healthy it’s like Teflon, and things don’t stick.” When it’s unhealthy, it becomes more like Velcro, attracting blood-borne gunk like flies to flypaper.

All of the major culprits in heart disease — overweight, lack of exercise, smoking, high cholesterol, high blood pressure, high levels of homocysteine and lipoprotein (a) — damage the endothelium. And a damaged endothelium doesn’t make enough NO, which results in more damage in an increasingly dangerous spiral. “But we can restore endothelial health and the lining of the vessel through exercise and nutrition,” Dr. Cooke says. Certain nutritional supplements (like arginine) and drugs used to treat heart disease (like aspirin and statins) can also help.

By the Numbers

If doctors could measure endothelial function — how blood vessels behave — they would have a good indication of your nitric oxide production, and in fact, your overall risk for coronary heart disease (CHD). Measuring endothelial function is like asking your arteries, “How’s it going?” If the answer is “well,” your arteries are happy with the composition of the blood and are probably relatively free of plaque.

Doctors can measure endothelial function in various ways, most of which involve using ultrasound to measure changes in the diameter of certain arteries. This testing is usually used for research purposes only. But soon there may be a way to test endothelial function right in the doctor’s office. In late 2000 the FDA approved a new, noninvasive instrument called CVProfilor DO-2020 that can measure the elasticity of your arteries, an indication of NO production. Normal ranges vary depending on your age and sex. The test isn’t in routine use yet, but that day may be coming.

Quick Tips

Eat more foods that contain the amino acid arginine, from which NO is produced. This includes beans, soy, almonds, walnuts, oats, and such cold-water fish as salmon, tuna, and mackerel.
Cut your intake of saturated fat. Just one meal high in saturated fat can temporarily cut endothelial function almost in half.
Exercise. The increased blood flow that occurs during exercise encourages the endothelium to make more NO. Over the long term, if you exercise every day, your endothelial cells not only release more NO but also make more of the enzyme that converts arginine into NO.