Vitamin D Deficiency in Patients with Congestive Heart Failure: Mechanisms, Manifestations, and Management
Southern Medical Journal, 05/03/2011
Clinical Article
Patel R et al. – According to current guidelines and research, vitamin D goals of >20 ng/ml in most patients with CHF and >30 ng/ml in those with secondary hyperparathyroidism seem to be appropriate to aim for.
- Recent research suggests that vitamin D may play a role in cardiovascular (CV) health.
- Although its exact role is still debated and is a matter of controversy, vitamin D deficiency has been linked to increased prevalence of CV risk factors and events.
- Factors that predispose persons with congestive heart failure (CHF) to hypovitaminosis D include nutritional deficiency, decreased skin production, reduced intestinal absorption, and hepatorenal disease.
- It is possible that low vitamin D can in turn aggravate CHF.
- The extent of deficiency can be severe enough to cause hypocalcemia, secondary hyperparathyroidism, osteomalacia, and decreased bone density.
- No clear data exist showing improvement in CV clinical outcomes with vitamin D replacement.
- Screening is advocated in most patients, although benefits of replacement are most likely to accrue in those with severe lack or with abnormalities of calcium–parathyroid–bone metabolism.
