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Vitamin D supplements cut heart attack risk by 52%. Why?

empirical.health

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Re: Vitamin D supplements cut heart attack risk by 52%. Why?

#31

Post by classichasclass »

tehjoker wrote: post #3
brandonb wrote: post #2

This was a write-up of a new study (TARGET-D) that used vitamin D supplements -- with the supplement amount guided by blood testing -- to reduce heart attack risk. I've been working in heart health in 10 years and I was surprised at the magnitude of the effect here. I hope it holds up as they move toward the final publication. Vitamin D supplementation is cheap and this could have a huge benefit.

Would it change practice substantially? I thought that typically vitamin D levels are measured at least annually and treated if low.

No, not typically. Myself I would usually order one either on specific request, or to investigate things like osteoporosis or pathologic fractures, but not as screening. USPSTF does not currently recommend vitamin D screening either in asymptomatic, non-pregnant adults ( https://www.uspreventiveservicestaskforce.org/uspstf/recomme... ).

Re: Vitamin D supplements cut heart attack risk by 52%. Why?

#32

Post by detourdog »

Aurornis wrote: post #25

The headline is poorly worded. The 52% number was for people with Vitamin D levels within a certain range, whether or not they took supplements EDIT: The study was also performed exclusively on patients who presented with acute coronary syndrome. Average age was over 60, nearly 80% were men, and half had already had at least one heart attack. Keep that context in mind when reading numbers about the patients in the st…

I don't doubt you but I also wonder what you base this information on.

In 2020 I test results for vitamin D was ridiculous low. I have been taking supplements

Jan 02, 2020 4:32 pm 25-Hydroxy Vitamin D Total 9 ng/mL 30-100 ng/mL

I took me five years just to get to something close to the lowest end of normal.

I was started on supplements in the in 2k IU and after poor progress boosted to 5k IU everyday to get to this level.

I have been spending the past year on a sailboat instead of server room and look forward to seeing my test results.

Re: Vitamin D supplements cut heart attack risk by 52%. Why?

#33

Post by detourdog »

classichasclass wrote: post #31
tehjoker wrote: post #3

Earlier quoted context omitted.

Would it change practice substantially? I thought that typically vitamin D levels are measured at least annually and treated if low.

No, not typically. Myself I would usually order one either on specific request, or to investigate things like osteoporosis or pathologic fractures, but not as screening. USPSTF does not currently recommend vitamin D screening either in asymptomatic, non-pregnant adults ( https://www.uspreventiveservicestaskforce.org/uspstf/recomme... ).

I moved to a different doctor and it was part of their normal blood work.

Re: Vitamin D supplements cut heart attack risk by 52%. Why?

#35

Post by brandonb »

Aurornis wrote: post #25

The headline is poorly worded. The 52% number was for people with Vitamin D levels within a certain range, whether or not they took supplements EDIT: The study was also performed exclusively on patients who presented with acute coronary syndrome. Average age was over 60, nearly 80% were men, and half had already had at least one heart attack. Keep that context in mind when reading numbers about the patients in the st…

> My doctor said she’s seeing a huge number of patients coming back with excessively high Vitamin D levels after taking supplement doses recommended by influencers. It happened to me, too, with what I though was a conservative dose of Vitamin D (5K IU, not even taken every day)

IMO that’s part of what’s interesting about this study design — they tested vitamin D blood levels and adjusted the supplement dose based on that. This seems like a much better approach than taking a high dose blindly.

I think the headline is accurate. The 52% number is from the experiment arm (participants who received a vitamin D supplement, with the quantity guided by blood testing). While it’s technically possible for the supplement dosage to be calculated as zero, 85% of participants were deficient at baseline, so this isn’t the main effect.

Re: Vitamin D supplements cut heart attack risk by 52%. Why?

#36

Post by Aurornis »

detourdog wrote: post #32
Aurornis wrote: post #25

The headline is poorly worded. The 52% number was for people with Vitamin D levels within a certain range, whether or not they took supplements EDIT: The study was also performed exclusively on patients who presented with acute coronary syndrome. Average age was over 60, nearly 80% were men, and half had already had at least one heart attack. Keep that context in mind when reading numbers about the patients in the st…

I don't doubt you but I also wonder what you base this information on. In 2020 I test results for vitamin D was ridiculous low. I have been taking supplements Jan 02, 2020 4:32 pm 25-Hydroxy Vitamin D Total 9 ng/mL 30-100 ng/mL I took me five years just to get to something close to the lowest end of normal. I was started on supplements in the in 2k IU and after poor progress boosted to 5k IU everyday to get to this l…

My own experience getting a too-high result from supplementing 5K IU several times a week. When it came up, my doctor said I wasn't alone and that she's seeing a lot of people come back too high.

> I took me five years just to get to something close to the lowest end of normal.

Five years of supplementing to get up to 30ng/mL? Something is wrong. Could your supplements have not actually contained any real amount of Vitamin D? Certain malabsorption disorders also reduce Vitamin D absorption, for example.

Re: Vitamin D supplements cut heart attack risk by 52%. Why?

#37

Post by Aurornis »

brandonb wrote: post #35
Aurornis wrote: post #25

The headline is poorly worded. The 52% number was for people with Vitamin D levels within a certain range, whether or not they took supplements EDIT: The study was also performed exclusively on patients who presented with acute coronary syndrome. Average age was over 60, nearly 80% were men, and half had already had at least one heart attack. Keep that context in mind when reading numbers about the patients in the st…

> My doctor said she’s seeing a huge number of patients coming back with excessively high Vitamin D levels after taking supplement doses recommended by influencers. It happened to me, too, with what I though was a conservative dose of Vitamin D (5K IU, not even taken every day) IMO that’s part of what’s interesting about this study design — they tested vitamin D blood levels and adjusted the supplement dose based on…

> I think the headline is accurate. The 52% number is from the experiment arm (participants who received a vitamin D supplement, with the quantity guided by blood testing). While it’s technically possible for the supplement dosage to be calculated as zero, 85% of participants were deficient at baseline, so this isn’t the main effect.

Yes, but it's also important to note that the study wasn't on a representative sample of the general population. They recruited people who had acute coronary syndrome. The average age was over 60 years old, 80% were men, and half of them had already had at least one heart attack.

Re: Vitamin D supplements cut heart attack risk by 52%. Why?

#38

Post by tylerhou »

detourdog wrote: post #32
Aurornis wrote: post #25

The headline is poorly worded. The 52% number was for people with Vitamin D levels within a certain range, whether or not they took supplements EDIT: The study was also performed exclusively on patients who presented with acute coronary syndrome. Average age was over 60, nearly 80% were men, and half had already had at least one heart attack. Keep that context in mind when reading numbers about the patients in the st…

I don't doubt you but I also wonder what you base this information on. In 2020 I test results for vitamin D was ridiculous low. I have been taking supplements Jan 02, 2020 4:32 pm 25-Hydroxy Vitamin D Total 9 ng/mL 30-100 ng/mL I took me five years just to get to something close to the lowest end of normal. I was started on supplements in the in 2k IU and after poor progress boosted to 5k IU everyday to get to this l…

A big problem is that the range that we have decided to call “normal” might not actually be a normal range.

For example, 50% of surfers were found to have insufficient vitamin D in one study. https://pubmed.ncbi.nlm.nih.gov/17426097/

There are at least two possible conclusions that you could draw. One conclusion is that we all need vitamin D supplementation regardless of how much sun exposure we receive.

Another conclusion is that we might want to reevaluate what we consider the normal range to be, especially when we are deciding a range for a specific individual.

Re: Vitamin D supplements cut heart attack risk by 52%. Why?

#39

Post by rodrig3 »

This seems like a critical update on what we know about the impact of vitamin D on cardiovascular health. Perhaps the highest value is that "unlike earlier vitamin D randomized trials that used standard doses, the TARGET-D trial personalized the doses based on the results of each participant’s blood test." (https://newsroom.heart.org/news/heart-attack-risk-halved-in-...)

It wasn't too long ago that evidence was mixed on benefits in this area: https://www.sciencedirect.com/science/article/pii/S096007602...

Nice find!

Re: Vitamin D supplements cut heart attack risk by 52%. Why?

#40

Post by tim-tday »

Aurornis wrote: post #25

The headline is poorly worded. The 52% number was for people with Vitamin D levels within a certain range, whether or not they took supplements EDIT: The study was also performed exclusively on patients who presented with acute coronary syndrome. Average age was over 60, nearly 80% were men, and half had already had at least one heart attack. Keep that context in mind when reading numbers about the patients in the st…

If the vitamin d levels are not due to supplements the answer is that people who go outside get more sun and more exercise.
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