This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (74)  • Contact me when this article is cited  Related Content  • Related letter  • Related article  • Similar articles in this journal  Topic Collections  • Men's Health  • Men's Health, Other  • Cardiovascular System  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic  Social Bookmarking   What's this?

A Prospective Study

Edward Giovannucci, MD, ScD; Yan Liu, MS; Bruce W. Hollis, MD, PhD; Eric B. Rimm, ScD

Arch Intern Med. 2008;168(11):1174-1180.

Background  Vitamin D deficiency may be involved in the development of atherosclerosis and coronary heart disease in humans.

Methods  We assessed prospectively whether plasma 25-hydroxyvitamin D (25[OH]D) concentrations are associated with risk of coronary heart disease. A nested case-control study was conducted in 18 225 men in the Health Professionals Follow-up Study; the men were aged 40 to 75 years and were free of diagnosed cardiovascular disease at blood collection. The blood samples were returned between April 1, 1993, and November 30, 1999; 99% were received between April 1, 1993, and November 30, 1995. During 10 years of follow-up, 454 men developed nonfatal myocardial infarction or fatal coronary heart disease. Using risk set sampling, controls (n = 900) were selected in a 2:1 ratio and matched for age, date of blood collection, and smoking status.

Results  After adjustment for matched variables, men deficient in 25(OH)D (15 ng/mL [to convert to nanomoles per liter, multiply by 2.496]) were at increased risk for MI compared with those considered to be sufficient in 25(OH)D (30 ng/mL) (relative risk [RR], 2.42; 95% confidence interval [CI], 1.53-3.84; P < .001 for trend). After additional adjustment for family history of myocardial infarction, body mass index, alcohol consumption, physical activity, history of diabetes mellitus and hypertension, ethnicity, region, marine -3 intake, low- and high-density lipoprotein cholesterol levels, and triglyceride levels, this relationship remained significant (RR, 2.09; 95% CI, 1.24-3.54; P = .02 for trend). Even men with intermediate 25(OH)D levels were at elevated risk relative to those with sufficient 25(OH)D levels (22.6-29.9 ng/mL: RR, 1.60 [95% CI, 1.10-2.32]; and 15.0-22.5 ng/mL: RR, 1.43 [95% CI, 0.96-2.13], respectively).

Conclusion  Low levels of 25(OH)D are associated with higher risk of myocardial infarction in a graded manner, even after controlling for factors known to be associated with coronary artery disease.

Author Affiliations: Departments of Nutrition (Drs Giovannucci and Rimm and Ms Liu) and Epidemiology (Drs Giovannucci and Rimm), Harvard School of Public Health, Boston, Massachusetts; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston (Drs Giovannucci and Rimm); and Department of Pediatrics, Medical University of South Carolina, Charleston (Dr Hollis).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED LETTER

A Ray of Sunshine for the Vitamin D–Heart Hypothesis
Beatrice Golomb, Eli Aronoff-Spencer, Michael Steadman, Winnie Wu, and Arthur Yan
Arch Intern Med. 2009;169(4):416-417.
EXTRACT | FULL TEXT  

RELATED ARTICLE

In This Issue of Archives of Internal Medicine
Arch Intern Med. 2008;168(11):1134.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Association between pre-diagnostic circulating vitamin D concentration and risk of colorectal cancer in European populations:a nested case-control study
Jenab et al.
BMJ 2010;340:b5500-b5500.
ABSTRACT | FULL TEXT  

Vitamin D, Race, and Cardiovascular Mortality: Findings From a National US Sample
Fiscella and Franks
Ann Fam Med 2010;8:11-18.
ABSTRACT | FULL TEXT  

Vitamin D insufficiency and health outcomes over 5 y in older women
Bolland et al.
Am. J. Clin. Nutr. 2010;91:82-89.
ABSTRACT | FULL TEXT  

Role of Vitamin D in Adults Requiring Nutrition Support
Pittas et al.
JPEN J Parenter Enteral Nutr 2010;34:70-78.
ABSTRACT | FULL TEXT  

Adiposity, Cardiometabolic Risk, and Vitamin D Status: The Framingham Heart Study
Cheng et al.
Diabetes 2010;59:242-248.
ABSTRACT | FULL TEXT  

Vitamin D Needs of Preterm Infants
Taylor et al.
NeoReviews 2009;10:e590-e599.
ABSTRACT | FULL TEXT  

25-Hydroxyvitamin D Levels, Race, and the Progression of Kidney Disease
Melamed et al.
J. Am. Soc. Nephrol. 2009;20:2631-2639.
ABSTRACT | FULL TEXT  

A new role for vitamin D receptor activation in chronic kidney disease
Valdivielso et al.
Am. J. Physiol. Renal Physiol. 2009;297:F1502-F1509.
ABSTRACT | FULL TEXT  

Serum 25-Hydroxyvitamin D Levels Among US Children Aged 1 to 11 Years: Do Children Need More Vitamin D?
Mansbach et al.
Pediatrics 2009;124:1404-1410.
ABSTRACT | FULL TEXT  

Vitamin D Status and the Risk of Cardiovascular Disease Death
Kilkkinen et al.
Am J Epidemiol 2009;170:1032-1039.
ABSTRACT | FULL TEXT  

Vitamin D Supplements vs Plasma Level
Glaser
Arch Intern Med 2009;169:1536-1536.
FULL TEXT  

Vitamin D Supplements vs Plasma Level--Reply
Golomb
Arch Intern Med 2009;169:1536-1537.
FULL TEXT  

Vitamin D and the Cardiovascular System
Artaza et al.
CJASN 2009;4:1515-1522.
ABSTRACT | FULL TEXT  

Vitamin D Status and Cardiometabolic Risk Factors in the United States Adolescent Population
Reis et al.
Pediatrics 2009;124:e371-e379.
ABSTRACT | FULL TEXT  

1,25(OH)2 Vitamin D Inhibits Foam Cell Formation and Suppresses Macrophage Cholesterol Uptake in Patients With Type 2 Diabetes Mellitus
Oh et al.
Circulation 2009;120:687-698.
ABSTRACT | FULL TEXT  

Primary and Secondary Prevention of Cardiovascular Diseases: A Practical Evidence-Based Approach
O'Keefe et al.
Mayo Clin Proc. 2009;84:741-757.
ABSTRACT | FULL TEXT  

25-Hydroxyvitamin D Levels Inversely Associate with Risk for Developing Coronary Artery Calcification
de Boer et al.
J. Am. Soc. Nephrol. 2009;20:1805-1812.
ABSTRACT | FULL TEXT  

Low Calcidiol Levels and Coronary Artery Calcification: True, True, and Related?
Melamed and Thadhani
J. Am. Soc. Nephrol. 2009;20:1663-1665.
FULL TEXT  

Plasma Parathyroid Hormone and the Risk of Cardiovascular Mortality in the Community
Hagstrom et al.
Circulation 2009;119:2765-2771.
ABSTRACT | FULL TEXT  

Circulating Calcitriol Concentrations and Total Mortality
Zittermann et al.
Clin. Chem. 2009;55:1163-1170.
ABSTRACT | FULL TEXT  

Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers
Zittermann et al.
Am. J. Clin. Nutr. 2009;89:1321-1327.
ABSTRACT | FULL TEXT  

Nutrient supplements and cardiovascular disease: a heartbreaking story
Lichtenstein
J. Lipid Res. 2009;50:S429-S433.
ABSTRACT | FULL TEXT  

Demographic Differences and Trends of Vitamin D Insufficiency in the US Population, 1988-2004
Ginde et al.
Arch Intern Med 2009;169:626-632.
ABSTRACT | FULL TEXT  

A Ray of Sunshine for the Vitamin D-Heart Hypothesis
Golomb et al.
Arch Intern Med 2009;169:416-417.
FULL TEXT  

Macro- and micronutrient dyshomeostasis in the adverse structural remodelling of myocardium
Weber et al.
Cardiovasc Res 2009;81:500-508.
ABSTRACT | FULL TEXT  

Vitamin D Deficiency: An Important, Common, and Easily Treatable Cardiovascular Risk Factor?
Lee et al.
J Am Coll Cardiol 2008;52:1949-1956.
ABSTRACT | FULL TEXT  

Differences in vitamin D status as a possible contributor to the racial disparity in peripheral arterial disease
Reis et al.
Am. J. Clin. Nutr. 2008;88:1469-1477.
ABSTRACT | FULL TEXT  

Commentary: Ecologic studies in identifying dietary risk factors for coronary heart disease and cancer
Grant
Int J Epidemiol 2008;37:1209-1211.
FULL TEXT  

Complementary and alternative medicine approaches to blood pressure reduction: An evidence-based review
Nahas
cfp 2008;54:1529-1533.
ABSTRACT | FULL TEXT  

Vitamin D in Health and Disease
Heaney
CJASN 2008;3:1535-1541.
ABSTRACT | FULL TEXT