title: Short-term vitamin D3 supplementation lowers plasma renin activity in patients with stable chronic heart failure: an open-label, blinded end point, randomized prospective trial (VitD-CHF trial).
abstract: BACKGROUND
  Many chronic heart failure (CHF) patients have low vitamin D (VitD) and high plasma renin activity (PRA), which are both associated with poor prognosis. Vitamin D may inhibit renin transcription and lower PRA. We investigated whether vitamin D3 (VitD3) supplementation lowers PRA in CHF patients.
  
  
  RESULTS
  We conducted a single-center, open-label, blinded end point trial in 101 stable CHF patients with reduced left ventricular ejection fraction. Patients were randomized to 6 weeks of 2,000 IU oral VitD3 daily or control. At baseline, mean age was 64 ± 10 years, 93% male, left ventricular ejection fraction 35% ± 8%, and 56% had VitD deficiency. The geometric mean (95% CI) of 25-hydroxyvitamin D3 increased from 48 nmol/L (43-54) at baseline to 80 nmol/L (75-87) after 6 weeks in the VitD3 treatment group and decreased from 47 nmol/L (42-53) to 44 nmol/L (39-49) in the control group (P < .001). The primary outcome PRA decreased from 6.5 ng/mL per hour (3.8-11.2) to 5.2 ng/mL per hour (2.9-9.5) in the VitD3 treatment group and increased from 4.9 ng/mL per hour (2.9-8.5) to 7.3 ng/mL per hour (4.5-11.8) in the control group (P = .002). This was paralleled by a larger decrease in plasma renin concentration in the VitD3 treatment group compared to control (P = .020). No significant changes were observed in secondary outcome parameters, including N-terminal pro-B-type natriuretic peptide natriuretic peptide and fibrosis markers.
  
  
  CONCLUSIONS
  Most CHF patients had VitD deficiency and high PRA levels. Six weeks of supplementation with 2,000 IU VitD3 increased 25-hydroxyvitamin D3 levels and decreased PRA and plasma renin concentration.
authors.affiliation: Department of Cardiology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Nicolas F
authors.initials: NF
authors.lastname: Schroten
authors.forename: Willem P T
authors.initials: WP
authors.lastname: Ruifrok
authors.forename: Lennaert
authors.initials: L
authors.lastname: Kleijn
authors.forename: Martin M
authors.initials: MM
authors.lastname: Dokter
authors.forename: Herman H
authors.initials: HH
authors.lastname: Silljé
authors.forename: Hiddo J
authors.initials: HJ
authors.lastname: Lambers Heerspink
authors.forename: Stephan J L
authors.initials: SJ
authors.lastname: Bakker
authors.forename: Ido P
authors.initials: IP
authors.lastname: Kema
authors.forename: Wiek H
authors.initials: WH
authors.lastname: van Gilst
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
authors.forename: Hans L
authors.initials: HL
authors.lastname: Hillege
authors.forename: Rudolf A
authors.initials: RA
authors.lastname: de Boer
mesh_terms: D000368:Aged; D002762:Cholecalciferol / Q000627:therapeutic use*; D002908:Chronic Disease; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012083:Renin / Q000097:blood*; D016037:Single-Blind Method; D014808:Vitamin D Deficiency / Q000188:drug therapy* / Q000209:etiology; D014815:Vitamins / Q000627:therapeutic use*
chemical_list: D014815:Vitamins; D002762:Cholecalciferol; D012083:Renin