Vitamin D deficiency linked to increased cardiac deaths among Blacks

black_coupleAfrican Americans are dying at a higher rate than whites from cardiovascular disease. One contributing factor may be vitamin D deficiency in this population.

In a study to be published in the Annals of Family Medicine on January 11, 2010, Kevin Fiscella, M.D., and colleagues report the results of their investigation of the role of vitamin D deficiency in cardiovascular death. Fiscella, a nationally known researcher in health disparities, lead a team of researchers in this NIH-funded project. They evaluated 15,000 adults, collecting data on vitamin D levels, body mass index, smoking history, and levels of C-reactive protein, among other measurements.

They found that vitamin D deficiency was associated with a 40 percent higher risk of death from cardiovascular disease for all study subjects. However, African Americans’ risk of cardiovascular death was 38 percent higher than whites. Fiscella et al also found that increased levels of poverty also were associated with increased risk of cardiovascular death.

Vitamin D deficiency is widespread around the world. Among otherwise healthy young adults in the United States, it’s estimated that 36 percent have low vitamin D levels. Some 57 percent of hospitalized adults are vitamin D deficient.

Vitamin D deficiency has been associated in epidemiological studies with diabetes, hypertension, some cancers, and with kidney and heart disease. As vitamin D is obtained from exposure to sunlight and through the diet, it may be a modifiable risk factor. Interventions with supplements or public campaigns to help increase sun exposure could help decrease death attributable to vitamin D deficiency.

Fiscella cautions against any rush to judgment on this matter. Previous observational studies indicating the health benefits of macronutrients — for example, vitamin E and beta-carotenes — have not panned out to be true when tested in clinical trials.

In addition to this caution, we need to keep in mind that the cause of the health inequities suffered by African Americans is not inherent biological differences. Even in this study, poverty was an independent risk factor — and poverty disproportionately affects the African-American. As long as these social inequities exist, racial health disparities will continue — no matter how much vitamin D we put in peoples’ diet.

Thursday, January 7th, 2010 at 14:48