Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

No cardiovascular benefit from vitamin D supplementation

Key clinical point: Vitamin D supplementation does not reduce the risk of major cardiovascular events.

Major finding: The incidence of major adverse cardiovascular events was the same in the vitamin D supplementation and placebo groups.

Study details: A meta-analysis of 21 randomized, placebo-controlled clinical trials involving 83,291 patients.

Disclosures: One author reported receiving funding from the National Institutes of Health and in-kind support from the pharmaceutical sector for a vitamin D study. No other disclosures were reported.

Citation:

Barbarawi M et al. JAMA Cardiol. 2019 Jun 19. doi: 10.1001/jamacardio.2019.1870.

Commentary:

The past decade has seen a nearly 100-fold increase in vitamin D testing and supplementation, driven by a widespread fascination with the notion of vitamin D as a panacea. Vitamin D assessments alone are costing the United States an estimated $350 million annually.

Population and cohort studies have shown a clear link between vitamin D status and cardiovascular disease, but this link is complicated by the possibility that low serum 25-hydroxyvitamin D levels may be a result of, rather than the cause of, cardiovascular disease.

The findings of this meta-analysis, that vitamin D supplementation does not reduce the risk of major cardiovascular events and all-cause mortality, should support efforts to reduce unnecessary vitamin D testing and treatment in populations not at risk for deficiency or to prevent cardiovascular disease morbidity and mortality.

Arshed A. Quyyumi, MD, and Ibhar Al Mheid, MD, are from the division of cardiology at Emory University, Atlanta. The comments are adapted from an accompanying editorial (JAMA Cardiol. 2019 Jun 19. doi:10.1001/jamacardio.2019.1906). No conflicts of interest were reported.