In a nationwide trial, supplementation with vitamin D did not result in a lower incidence of invasive cancer or cardiovascular events than placebo. Researchers conducted a randomized, placebo-controlled trial with a 2-by-2 factorial design, of vitamin D3 (cholecalciferol) at a dose of 2000 IU per day and marine n-3 (omega-3) fatty acids at a dose of 1 g day for the prevention of cancer and CVD among men aged ≥50 years and women aged ≥55 in the US. Primary end points were invasive cancer of any type and major CV events. Secondary end points included site-specific cancers, death from cancer, and additional CV events. Among the findings:
- 25,871 participants underwent randomization (including 5,106 black participants).
- Supplementation with vitamin D was not associated with a lower risk of either cancer or CVD.
- During a median follow-up of 5.3 years, cancer was diagnosed in 1,617 participants (793 in the vitamin D group and 824 in the placebo group; hazard ratio 0.96).
- A major CV event occurred in 805 participants (396 in the vitamin D group and 409 in the placebo group; HR 0.97).
- In the analyses of secondary end points, the HRs were: for death from cancer, 0.83; for breast cancer, 1.02; for prostate cancer, 0.88; for colorectal cancer, 1.09; for the expanded composite end point of major CV events plus coronary revascularization, 0.96; for myocardial infarction, 0.96; for stroke, 0.95; and for death from CV causes, 1.11.
Manson JE, Cook NR, Lee I-M, et al. Vitamin D supplements and prevention of cancer and cardiovascular disease. N Engl J Med. 2019;380:33-44. doi:10.1056/NEJMoa1809944.
This Week's Must Reads
TNF inhibitor prices rose despite increased drug class competition, San-Juan-Rodriguez A et al. JAMA Intern Med. 2019 Feb 18. doi: 10.1001/jamainternmed.2018.7656
List of medications linked to drug-induced lupus expands, Arnaud L et al. Ann Rheum Dis. 2019 Feb 4. doi: 10.1136/annrheumdis-2018-214598
HCV-infected patients in the ED should be tested for advanced liver fibrosis, Yu-Hsiang Hsieh Y-H. Am J Emerg Med. 2019;37:286-90
Baby boomers account for more than 74% of chronic HCV cases, Moore KJ et al. J Infect Public Health. 2019 Jan-Feb;12(1):32-6.
PERT alerts improve pulmonary embolism outcomes, Benninghoff M. Critical Care Congress 2019, Abstract 490
Must Reads in Cardiology
PAD tied to higher prevalence of LV diastolic dysfunction, Yanaka K et al. J Cardiol. 2019 Feb 18. doi: 10.1016/j.jjcc.2019.01.011
Possible mechanism for fluoroquinolone-induced aortopathy uncovered, Guzzardi DG et al. J Thorac Cardiovasc Surg. 2019;157:109-19.
Are Automated Office BP Readings More Accurate?, JAMA Intern Med; ePub 2019 Feb 4; Roerecke, et al
BMI Measurements and Intensive BP Management , Am J Med; ePub 2019 Feb 2; Oxlund, et al
Intensive BP Control & Risk of Dementia, JAMA; ePub 2019 Jan 28; SPRINT MIND Investigators