Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2011 Sep 27;58(14):1433-41.
doi: 10.1016/j.jacc.2011.03.069.

Vitamin D, parathyroid hormone, and cardiovascular events among older adults

Bryan Kestenbaum  1 , Ronit Katz, Ian de Boer, Andy Hoofnagle, Mark J Sarnak, Michael G Shlipak, Nancy S Jenny, David S Siscovick
Affiliations
Comparative Study

Vitamin D, parathyroid hormone, and cardiovascular events among older adults

Bryan Kestenbaum et al. J Am Coll Cardiol. .

Abstract

Objectives: 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).

Background: Vitamin D deficiency and PTH excess are common in older adults and may adversely affect cardiovascular health.

Methods: 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.

Results: 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.

Conclusions: 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.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Flow diagram of the study population
Exclusions are shown on the right hand side of the figure; additions to the study population are shown on the left hand side.
Figure 2
Figure 2. Association of 25-OHD concentration with mortality and myocardial infarction by subgroups
Continuous associations of 10 ng/ml lower 25-OHD concentration with all-cause mortality and incident myocardial infarction by subgroups, adjusted for the covariates in model 3.
See this image and copyright information in PMC

Comment in

References

    1. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2001;22:477–501. - PubMed
    1. van der Wielen RP, Lowik MR, van den Berg H, de Groot LC, Haller J, Moreiras O, van Staveren WA. Serum vitamin D concentrations among elderly people in Europe. Lancet. 1995;346:207–210. - PubMed
    1. Brunette MG, Chan M, Ferriere C, Roberts KD. Site of 1,25(OH)2 vitamin D3 synthesis in the kidney. Nature. 1978;276:287–289. - PubMed
    1. Kamycheva E, Sundsfjord J, Jorde R. Serum parathyroid hormone level is associated with body mass index. The 5th Tromso study. Eur J Endocrinol. 2004;151:167–172. - PubMed
    1. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–281. - PubMed

Publication types