Contribution of vitamin D deficiency to the risk of coronary heart disease in subjects with essential hypertension
| Autor: | Atieh Pajouhi, Manouchehr Nakhjavani, Sara Sheikhbahaei, Arash Aghajani Nargesi, Sadaf Esteghamati, Alireza Esteghamati, Behnam Heidari, Nima Hafezi-Nejad |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Framingham Risk Score business.industry Proportional hazards model Hazard ratio 030204 cardiovascular system & hematology medicine.disease Essential hypertension vitamin D deficiency Surgery Coronary artery disease 03 medical and health sciences 0302 clinical medicine Quartile Internal medicine Cardiology Medicine 030212 general & internal medicine Risk factor Cardiology and Cardiovascular Medicine business |
| Zdroj: | Atherosclerosis. 244:165-171 |
| ISSN: | 0021-9150 |
| Popis: | Background Vitamin D deficiency is proposed as a risk factor for coronary heart disease (CHD). An inverse relation was observed between serum 25-Hydroxy-Vitamin-D level and incidence of hypertension. This study aimed to evaluate the predictive value of serum 25-Hydroxy-Vitamin-D in improvement of CHD risk-stratification in patients with hypertension. Methods In this cohort, we followed 1586 patients with essential hypertension (1078 diabetic and 508 non-diabetic) for 8.5 years. Physician-adjudicated first hard CHD event was the primary outcome. Cox regression analysis was used to investigate the association between 25-Hydroxy-Vitamin-D quartiles and incident CHD. 25-Hydroxy-Vitamin-D was also added to the Framingham Risk Score (FRS) and Net-Reclassification-Improvement (NRI) and Integrated-Discriminant-Improvement (IDI) were used to examine improved reclassification. Results During follow-up, 176 events were recorded. Patients in the lowest quartile of 25-Hydroxy-Vitamin-D experienced the most number of hard CHD events. A significant linear trend was observed in hazard ratios (HR) of incident hard CHD events in 25-Hydroxy-Vitamin-D quartiles which remained significant after multiple adjustments for conventional CHD risk-factors (HRs in full-adjusted model: 2.87 [1.76–4.70] for 1st quartile, 2.31 [1.39–3.83] for 2nd quartile and 1.87 [1.15–3.03] for 3rd quartile, compared with the highest quartile; p-for-trend Conclusion We observed that serum 25-Hydroxy-Vitamin-D is independently associated with future hard CHD events and improves its prediction in patients with essential hypertension. Addition of serum 25-Hydroxy-Vitamin-D to CHD risk-estimation models may have additive values. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect