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Vitamin D, parathyroid hormone, and cardiovascular events among older adults.
Tuesday,2012-11-06 12:25 America/Los_Angeles — eenright
| Title | Vitamin D, parathyroid hormone, and cardiovascular events among older adults. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Kestenbaum, B, Katz, R, de Boer, I, Hoofnagle, A, Sarnak, MJ, Shlipak, MG, Jenny, NS, Siscovick, DS |
| Journal | J Am Coll Cardiol |
| Volume | 58 |
| Issue | 14 |
| Pagination | 1433-41 |
| Date Published | 2011 Sep 27 |
| ISSN | 1558-3597 |
| Keywords | Age Factors, Aged, Aged, 80 and over, Biomarkers, Cardiovascular Diseases, Cohort Studies, Female, Follow-Up Studies, Humans, Male, Parathyroid Hormone, Prospective Studies, Vitamin D |
| Abstract | <p><b>OBJECTIVES: </b>The aim of this study was to evaluate associations of 25-hydroxyvitamin D (25-OHD) and parathyroid hormone (PTH) concentrations separately and in combination with incident cardiovascular events and mortality during 14 years of follow-up in the CHS (Cardiovascular Health Study).</p><p><b>BACKGROUND: </b>Vitamin D deficiency and PTH excess are common in older adults and may adversely affect cardiovascular health.</p><p><b>METHODS: </b>A total of 2,312 participants who were free of cardiovascular disease at baseline were studied. Vitamin D and intact PTH were measured from previously frozen serum using mass spectrometry and a 2-site immunoassay. Outcomes were adjudicated cases of myocardial infarction, heart failure, cardiovascular death, and all-cause mortality.</p><p><b>RESULTS: </b>There were 384 participants (17%) with serum 25-OHD concentrations <15 ng/ml and 570 (25%) with serum PTH concentrations ≥ 65 pg/ml. After adjustment, each 10 ng/ml lower 25-OHD concentration was associated with a 9% greater (95% confidence interval [CI]: 2% to 17% greater) relative hazard of mortality and a 25% greater (95% CI: 8% to 44% greater) relative hazard of myocardial infarction. Serum 25-OHD concentrations <15 ng/ml were associated with a 29% greater (95% CI: 5% to 55% greater) risk for mortality. Serum PTH concentrations ≥ 65 pg/ml were associated with a 30% greater risk for heart failure (95% CI: 6% to 61% greater) but not other outcomes. There was no evidence of an interaction between serum 25-OHD and PTH concentrations and cardiovascular events.</p><p><b>CONCLUSIONS: </b>Among older adults, 25-OHD deficiency is associated with myocardial infarction and mortality; PTH excess is associated with heart failure. Vitamin D and PTH might influence cardiovascular risk through divergent pathways.</p> |
| DOI | 10.1016/j.jacc.2011.03.069 |
| Alternate Journal | J. Am. Coll. Cardiol. |
| PubMed ID | 21939825 |
| PubMed Central ID | PMC3210558 |
| Grant List | R01AG027002 / AG / NIA NIH HHS / United States N01-HC-85085 / HC / NHLBI NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01-HC-85081 / HC / NHLBI NIH HHS / United States U01-HL080295 / HL / NHLBI NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States 1R01HL084443-01A2 / HL / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01-HC-85082 / HC / NHLBI NIH HHS / United States N01-HC-55222 / HC / NHLBI NIH HHS / United States N01-HC-85083 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States N01-HC-85080 / HC / NHLBI NIH HHS / United States R01 HL084443 / HL / NHLBI NIH HHS / United States R01 AG027002 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States R01 HL084443-03 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States N01-HC-85084 / HC / NHLBI NIH HHS / United States |