Vitamin D Supplementation in the Treatment of Chronic Heart Failure: A Meta-analysis of Randomized Controlled Trials

Clin Cardiol. 2016 Jan;39(1):56-61. doi: 10.1002/clc.22473. Epub 2015 Sep 28.

Abstract

Background: In recent years, there has been growing evidence that vitamin D deficiency is associated with the development and progression of chronic heart failure (CHF).

Hypothesis: Additional supplementation of vitamin D may have protective effects in patients with CHF.

Methods: We searched PubMed, Embase, and Cochrane databases through June 2015 and included 7 randomized controlled trials that investigated the effects of vitamin D on cardiovascular outcomes in patients with CHF. Then, we performed a meta-analysis of clinical trials to confirm whether vitamin D supplementation is beneficial in CHF patients. The weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using fixed- or random-effects models.

Results: Our pooled results indicated that additional supplementation of vitamin D was not superior to conventional treatment in terms of left ventricular ejection fraction, N-terminal pro-B-type natriuretic peptide, and 6-minute walk distance. Moreover, vitamin D supplementation was associated with significant decreases in the levels of tumor necrosis factor-α (WMD: -2.42 pg/mL, 95% CI: -4.26 to -0.57, P < 0.05), C-reactive protein (WMD: -0.72 mg/L, 95% CI: -1.42 to -0.02, P < 0.05), and parathyroid hormone (WMD: -13.44 pg/mL, 95% CI: -21.22 to -5.67, P < 0.05).

Conclusions: Vitamin D supplementation may decrease serum levels of parathyroid hormone and inflammatory mediators in CHF patients, whereas it has no beneficial effects on improvement of left ventricular function and exercise tolerance.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • C-Reactive Protein / analysis
  • Chi-Square Distribution
  • Chronic Disease
  • Dietary Supplements*
  • Exercise Tolerance
  • Heart Failure / blood
  • Heart Failure / diagnosis
  • Heart Failure / drug therapy*
  • Heart Failure / epidemiology
  • Heart Failure / physiopathology
  • Humans
  • Inflammation Mediators / blood
  • Natriuretic Peptide, Brain / blood
  • Parathyroid Hormone / blood
  • Peptide Fragments / blood
  • Randomized Controlled Trials as Topic
  • Recovery of Function
  • Risk Factors
  • Stroke Volume
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / blood
  • Ventricular Function, Left
  • Vitamin D / therapeutic use*
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / drug therapy*
  • Vitamin D Deficiency / epidemiology

Substances

  • Inflammation Mediators
  • PTH protein, human
  • Parathyroid Hormone
  • Peptide Fragments
  • Tumor Necrosis Factor-alpha
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • Vitamin D
  • C-Reactive Protein