Vitamin D and Congestive Heart Failure (CHF)

Congestive heart failure

Heart failure is also called congestive heart failure (CHF).  CHF occurs when the heart can no longer pump enough blood to the rest of the body. Nearly 5 million Americans currently suffer from heart failure. Annually, about 550,000 new cases of CHF are now diagnosed and 300,000 die from the condition.

Risk factors

Risk factors for heart failure include:

• Coronary artery disease
• High blood pressure
• Diseases that damage or weaken the heart muscle or valves

Heart failure is most common in people who are:

• Greater than 65 years of age
• African-American, Hispanic, and Native American (Generally, these groups have higher blood pressure and more diabetes than white Americans.)
• Female

Sunlight exposure and risk of CHF

African-Americans may also have a higher risk of CHF because they have darker skin and lower vitamin D levels. African-Americans have 40% lower vitamin D blood levels than white Americans. People living in the southern regions of Australia had a higher summer-winter difference in CHF mortality rates than those living in the northern regions. Solar ultraviolet-B (UVB) doses change more during the year in the southern regions than in the northern regions. This accounts for the seasonal variations in vitamin D levels.

Vitamin D and CHF

Vitamin D levels

A number of studies have found that people with CHF have lower vitamin D blood levels:

• British infants who were dark-skinned and breast fed had CHF.
• In Austria, people with suspected coronary heart disease and low vitamin D levels had nearly three times the risk of dying from CHF than those with adequate vitamin D levels.
• Patients who received heart transplants appeared to have low vitamin D levels.
• In two German studies, people with CHF and higher vitamin D levels had higher survival rates.

How vitamin D works

Vitamin D may lower the risk of CHF because it:

• Reduces the risk of diseases that may lead to CHF (high blood pressure, diabetes, and coronary heart disease)
• Strengthens the heart muscle
• Reduces inflammation

One study supports the theory that vitamin D reduces inflammation. Another study found little effect of vitamin D plus calcium supplements on CHF or quality of life.

Prevention

Vitamin D and calcium

Children with rickets and severe heart failure can be successfully treated with vitamin D plus calcium.

Treatment

One study showed showed patients with heart failure who had low baseline levels of vitamin D were almost 3 times more likely to die over the five years of the study (30). A randomized, double-blind placebo controlled trial of 80 children with congestive heart failure and dilated cardiomyopathy recently published in Pediatric Cardiology showed a high daily dose of  vitamin D3 significantly improved heart failure; ejection fraction went from 37% to 52% in just 12 weeks of high dose vitamin D3 treatment (31). An even more recent 2013 prospective study of 100 adult patients published in the journal Congestive Heart Failure showed high dose vitamin D significantly improved NYHA classifications (P<.001), ejection fraction (P<.001), hsCRP (P<.001) and BDNF (P=.<001) (32).

Acknowledgements

This evidence summary was written by:

William B. Grant, Ph.D.
Sunlight, Nutrition, and Health Research Center (SUNARC)
P.O. Box 641603
San Francisco, CA 94164-1603, USA
www.sunarc.org
wbgrant@infionline.net

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