title: Cardiovascular disease and vitamin D supplementation: trial analysis, systematic review, and meta-analysis.
abstract: BACKGROUND
  Low 25-hydroxyvitamin D status has been associated with increased cardiovascular events in epidemiologic studies.
  
  
  OBJECTIVE
  We assessed whether vitamin D supplementation reduces cardiac failure, myocardial infarction (MI), and stroke through an analysis of the Randomised Evaluation of Calcium Or vitamin D (RECORD) randomized controlled trial (RCT), a systematic review, and a meta-analysis.
  
  
  METHODS
  Two analyses were undertaken. The first analysis was a trial analysis. The RECORD was a factorial RCT that compared vitamin D₃ (800 IU/d), calcium (1000 mg/d), vitamin D plus calcium, and a placebo. Cardiovascular events were collected throughout the trial and 3-y posttrial follow-up. Data were analyzed by using Cox regression. The second analysis was a systematic review. MEDLINE, EMBASE, CENTRAL, conference abstracts, and ongoing trials were searched for RCTs that evaluated vitamin D from 1980 to 2013. RCTs with ≥1 y of follow-up and participants mean or median age ≥60 y were included. Meta-analyses were based on a Bayesian fixed-effects model by using a complementary log-log link function to account for varying lengths of follow-up.
  
  
  RESULTS
  In the trial analysis, we showed that, for the 5292 participants in the RECORD trial, HRs (95% CIs) for vitamin D compared with no vitamin D for cardiac failure, MI, and stroke were 0.75 (0.58, 0.97), 0.97 (0.75,1.26), and 1.06 (0.8, 1.32), respectively. Twenty-one studies met the inclusion criteria for the systematic review (n = 13,033). Estimated HRs (credible intervals) for vitamin D compared with the placebo or control for on-study events for cardiac failure, MI, and stroke were 0.82 (0.58, 1.15), 0.96 ( 0.83, 1.10), and 1.07 (0.91, 1.29), respectively.
  
  
  CONCLUSIONS
  Vitamin D supplementation might protect against cardiac failure in older people but does not appear to protect against MI or stroke.
authors: From the Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom (JAF, GSM, and AA); the Department of Medicine, University of Auckland, Auckland, New Zealand (MB and AG); and the Section of Aging and Health, University of Dundee, Dundee, United Kingdom (MW).
authors: John A
authors: JA
authors: Ford
authors: From the Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom (JAF, GSM, and AA); the Department of Medicine, University of Auckland, Auckland, New Zealand (MB and AG); and the Section of Aging and Health, University of Dundee, Dundee, United Kingdom (MW).
authors: Graeme S
authors: GS
authors: MacLennan
authors: From the Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom (JAF, GSM, and AA); the Department of Medicine, University of Auckland, Auckland, New Zealand (MB and AG); and the Section of Aging and Health, University of Dundee, Dundee, United Kingdom (MW).
authors: Alison
authors: A
authors: Avenell
authors: From the Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom (JAF, GSM, and AA); the Department of Medicine, University of Auckland, Auckland, New Zealand (MB and AG); and the Section of Aging and Health, University of Dundee, Dundee, United Kingdom (MW).
authors: Mark
authors: M
authors: Bolland
authors: From the Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom (JAF, GSM, and AA); the Department of Medicine, University of Auckland, Auckland, New Zealand (MB and AG); and the Section of Aging and Health, University of Dundee, Dundee, United Kingdom (MW).
authors: Andrew
authors: A
authors: Grey
authors: From the Health Services Research Unit, University of Aberdeen, Aberdeen, United Kingdom (JAF, GSM, and AA); the Department of Medicine, University of Auckland, Auckland, New Zealand (MB and AG); and the Section of Aging and Health, University of Dundee, Dundee, United Kingdom (MW).
authors: Miles
authors: M
authors: Witham
mesh_terms: D019587:Dietary Supplements; D019317:Evidence-Based Medicine; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014807:Vitamin D / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000178:diet therapy* / Q000503:physiopathology
chemical_list: D014807:Vitamin D