Vitamin D and Ischaemic Heart Disease: A Casual or A Causal Association?
- PDF / 594,540 Bytes
- 5 Pages / 595.276 x 790.866 pts Page_size
- 52 Downloads / 132 Views
COMMENTARY
Vitamin D and Ischaemic Heart Disease: A Casual or A Causal Association? Commentary on: “Raslan E et al. Association of Vitamin D Deficiency with Chronic Stable Angina: A Case–Control Study” Damiano Rizzoni1,2 · Marco Rizzoni3 · Matteo Nardin1 Received: 9 January 2019 / Accepted: 16 January 2019 © Italian Society of Hypertension 2019
Keywords Vitamin D · Ischemic heart disease · Angina · Coronary arteries
1 Introduction The aim of the study by Raslan E et al. [1], published in the present issue of High Blood Pressure and Cardiovascular Prevention, was to assess vitamin D status among patients with chronic stable angina and to compare it with that of a matched control group. The Authors’ conclusion is that there is a significant association between vitamin D deficiency and the occurrence of chronic stable angina [1]. This is a non-randomized, case–control study, mainly based on interviewing questionnaires, and performed in a relative limited number of patients with angina pectoris as well as controls (n = 42 vs. 42). The study limitations are properly recognized by the Authors themselves; among them it should be mentioned the possibility of an imperfect matching of patients and controls; a selection bias might have occurred, as patients were selected from a tertiary hospital pool. Possible confounders, such as smoking, physical activity, hypertension and diabetes might have influenced the results obtained.
* Damiano Rizzoni [email protected] 1
Department of Clinical and Experimental Sciences, Clinica Medica, University of Brescia, c/o 2a Medicina Spedali Civili di Brescia, Piazza Spedali Civili 1, 25100 Brescia, Italy
2
Division of Medicine, Istituto Clinico Città di Brescia, Brescia, Italy
3
Department of Information Engineering, University of Brescia, Brescia, Italy
In addition, the case–control nature of the study, that did not include longitudinal observation or drug interventions, does not allow a proper evaluation of the causal relationships between the investigated variable (vitamin D plasma levels), and the occurrence of angina pectoris; however it is interesting to postulate a possible role of vitamin D deficiency as a potentially modifiable and underestimated risk factor for ischemic heart disease [1, 2]. The possible association between vitamin D circulating levels and coronary heart disease was addressed also in other previous recent studies [3–7], however, the issue is intriguing and controversial. Vitamin D, a fat-soluble prohormone, has wide-ranging roles in the regulation of many physiological processes through their interactions with the vitamin D receptors [2]. It plays a major role in bones and calcium metabolism. Vitamin D deficiency is not uncommon and it has been associated with many health-related issues including skeletal and non-skeletal complications. The association of low vitamin D and cardiovascular diseases and risk factors has been explored in both animal and human studies. However, studies and trials on the effect of vitamin D supplementation on
Data Loading...
