Low Dietary Vitamin D in Mid-life Predicts Total Mortality in Men with Hypertension: the Honolulu Heart Program

Overview

Journal J Am Coll Nutr

Specialty Nutritional Sciences

Date 2014 Apr 15

PMID 24724770

Citations 3

Authors

Gotaro Kojima

Christina L Bell

Randi Chen

G Webster Ross

Robert D Abbott

Lenore Launer

Felix Lui

Kamal Masaki

Affiliations

Soon will be listed here.

Abstract

Background: Vitamin D deficiency was associated with total mortality in previous epidemiological studies. Little is known about the effects of dietary vitamin D intake on mortality. We examined the association between mid-life dietary vitamin D intake and 45-year total mortality.

Methods: The Honolulu Heart Program is a longitudinal cohort study of 8006 Japanese American men in Hawaii aged 45 to 68 at baseline (1965-1968). Mid-life dietary vitamin D intake was calculated from 24-hour dietary recall using Nutritionist IV v3 software. We divided subjects into quartiles of dietary vitamin D. Total mortality data were available over 45 years through 2010.

Results: Age-adjusted total mortality rates were higher in the lower quartiles of dietary vitamin D intake compared to the highest (p for trend = 0.011). Using Cox regression, low dietary vitamin D was significantly associated with total mortality; quartile (Q) 1 hazard ratio (HR) = 1.14, 95% confidence interval (95% CI) = 1.07-1.22, p < 0.001; Q2 HR = 1.11, 95% CI = 1.04-1.18, p = 0.002; and Q3 HR = 1.08, 95% CI = 1.01-1.15, p = 0.027; Q4 = reference. After adjusting for age, kilocalories, cardiovascular risk factors, and prevalent chronic diseases, only Q2 remained significant (HR = 1.08, 95% CI = 1.00-1.15, p = 0.037). Among hypertensive subjects only, those in the lower 2 quartiles had higher total mortality; Q1 HR = 1.12, 95% CI = 1.01-1.25, p = 0.039, and Q2 HR = 1.13, 95% CI = 1.02-1.26, p = 0.025, compared to Q4. There was no significant relationship in subjects without hypertension.

Conclusions: Low dietary vitamin D intake in mid-life was a weak predictor of total mortality over 45 years of follow-up. We found a significant association between low dietary vitamin D intake and higher total mortality only among hypertensive subjects. Vitamin D may have cardioprotective effects.

Citing Articles

Association between serum 25-hydroxyvitamin D and vitamin D dietary supplementation and risk of all-cause and cardiovascular mortality among adults with hypertension.

Ye H, Li Y, Liu S, Zhang X, Liang H, Wang Y Nutr J. 2024; 23(1):33.

PMID: 38459491 PMC: 10924411. DOI: 10.1186/s12937-024-00914-8.

Vitamin D intake and all-cause and cause-specific mortality in Japanese men and women: the Japan Public Health Center-based prospective study.

Nanri A, Mizoue T, Goto A, Noda M, Sawada N, Tsugane S Eur J Epidemiol. 2023; 38(3):291-300.

PMID: 36719520 PMC: 9887248. DOI: 10.1007/s10654-023-00968-8.

Risk Factors of Vitamin D Deficiency in Chinese Ischemic Stroke Patients: A Cross-Sectional Study.

Miao H, Zhu H, Luan X, Huang G, Chen M, Yuan Z Front Aging Neurosci. 2021; 12:613498.

PMID: 33536895 PMC: 7849025. DOI: 10.3389/fnagi.2020.613498.

References

Virtanen J, Nurmi T, Voutilainen S, Mursu J, Tuomainen T . Association of serum 25-hydroxyvitamin D with the risk of death in a general older population in Finland. Eur J Nutr. 2010; 50(5):305-12. DOI: 10.1007/s00394-010-0138-3. View

WORTH R, Kagan A . Ascertainment of men of Japanese ancestry in Hawaii through World War II Selective Service registration. J Chronic Dis. 1970; 23(5):389-97. DOI: 10.1016/0021-9681(70)90022-6. View

Schmidt-Ott K, Kagiyama S, Phillips M . The multiple actions of angiotensin II in atherosclerosis. Regul Pept. 2000; 93(1-3):65-77. DOI: 10.1016/s0167-0115(00)00178-6. View

Jacobus C, Holick M, Shao Q, Chen T, Holm I, Kolodny J . Hypervitaminosis D associated with drinking milk. N Engl J Med. 1992; 326(18):1173-7. DOI: 10.1056/NEJM199204303261801. View

Block G, Cox C, Madans J, Schreiber G, Licitra L, Melia N . Vitamin supplement use, by demographic characteristics. Am J Epidemiol. 1988; 127(2):297-309. DOI: 10.1093/oxfordjournals.aje.a114805. View

Margolis K, Ray R, Van Horn L, Manson J, Allison M, Black H . Effect of calcium and vitamin D supplementation on blood pressure: the Women's Health Initiative Randomized Trial. Hypertension. 2008; 52(5):847-55. PMC: 2791957. DOI: 10.1161/HYPERTENSIONAHA.108.114991. View

Bjelakovic G, Gluud L, Nikolova D, Whitfield K, Wetterslev J, Simonetti R . Vitamin D supplementation for prevention of mortality in adults. Cochrane Database Syst Rev. 2011; (7):CD007470. DOI: 10.1002/14651858.CD007470.pub2. View

Rhoads G, Kagan A, Yano K . Usefulness of community surveillance for the ascertainment of coronary heart disease and stroke. Int J Epidemiol. 2013; 4(4):265-70. DOI: 10.1093/ije/4.4.265. View

Zittermann A, Schleithoff S, Koerfer R . Vitamin D and vascular calcification. Curr Opin Lipidol. 2007; 18(1):41-6. DOI: 10.1097/MOL.0b013e328011c6fc. View

10.

Cawthon P, Parimi N, Barrett-Connor E, Laughlin G, Ensrud K, Hoffman A . Serum 25-hydroxyvitamin D, parathyroid hormone, and mortality in older men. J Clin Endocrinol Metab. 2010; 95(10):4625-34. PMC: 3050100. DOI: 10.1210/jc.2010-0638. View

11.

Park M, Ross G, Petrovitch H, White L, Masaki K, Nelson J . Consumption of milk and calcium in midlife and the future risk of Parkinson disease. Neurology. 2005; 64(6):1047-51. DOI: 10.1212/01.WNL.0000154532.98495.BF. View

12.

Forrest K, Stuhldreher W . Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011; 31(1):48-54. DOI: 10.1016/j.nutres.2010.12.001. View

13.

Watson K, Abrolat M, Malone L, Hoeg J, Doherty T, Detrano R . Active serum vitamin D levels are inversely correlated with coronary calcification. Circulation. 1997; 96(6):1755-60. DOI: 10.1161/01.cir.96.6.1755. View

14.

Melamed M, Michos E, Post W, Astor B . 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med. 2008; 168(15):1629-37. PMC: 2677029. DOI: 10.1001/archinte.168.15.1629. View

15.

Tillotson J, Kato H, NICHAMAN M, Miller D, GAY M, Johnson K . Epidemiology of coronary heart disease and stroke in Japanese men living in Japan, Hawaii, and California: methodology for comparison of diet. Am J Clin Nutr. 1973; 26(2):177-84. DOI: 10.1093/ajcn/26.2.177. View

16.

de Zeeuw D, Agarwal R, Amdahl M, Audhya P, Coyne D, Garimella T . Selective vitamin D receptor activation with paricalcitol for reduction of albuminuria in patients with type 2 diabetes (VITAL study): a randomised controlled trial. Lancet. 2010; 376(9752):1543-51. DOI: 10.1016/S0140-6736(10)61032-X. View

17.

Anagnostis P, Athyros V, Adamidou F, Florentin M, Karagiannis A . Vitamin D and cardiovascular disease: a novel agent for reducing cardiovascular risk?. Curr Vasc Pharmacol. 2010; 8(5):720-30. DOI: 10.2174/157016110792006978. View

18.

Li Y, Qiao G, Uskokovic M, Xiang W, Zheng W, Kong J . Vitamin D: a negative endocrine regulator of the renin-angiotensin system and blood pressure. J Steroid Biochem Mol Biol. 2004; 89-90(1-5):387-92. DOI: 10.1016/j.jsbmb.2004.03.004. View

19.

Hankin J, Nomura A, Rhoads G . Dietary patterns among men of Japanese ancestry in Hawaii. Cancer Res. 1975; 35(11 Pt. 2):3259-64. View

20.

Schulman I, Zhou M, Raij L . Interaction between nitric oxide and angiotensin II in the endothelium: role in atherosclerosis and hypertension. J Hypertens Suppl. 2006; 24(1):S45-50. DOI: 10.1097/01.hjh.0000220406.46246.f2. View