Risk of Heart Failure Among Postmenopausal Women. (January 2015)

• Record Type: Journal Article
• Authors: Donneyong, Macarius M.; Hornung, Carlton A.; Taylor, Kira C.; Baumgartner, Richard N.; Myers, John A.; Eaton, Charles B.; Gorodeski, Eiran Z.; Klein, Liviu; Martin, Lisa W.; Shikany, James M.; Song, Yiqing; Li, Wenjun; Manson, JoAnn E.
• Is Part Of: Circulation. Volume 8:Number 1(2015)
• Publication Date: 2015-01
• Subjects: Heart failure -- Periodicals; 616.129005
• DOI: 10.1161/CIRCHEARTFAILURE.114.001738
• Languages: English
• ISSNs: 1941-3289

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Background—</title> <p>Vitamin D supplementation may be an inexpensive intervention to reduce heart failure (HF) incidence. However, there are insufficient data to support this hypothesis. This study evaluates whether vitamin D plus calcium (CaD) supplementation is associated with lower rates of HF in postmenopausal women and whether the effects differ between those at high versus low risk for HF.</p> </sec> <sec> <title>Methods and Results—</title> <p>Analyses were restricted to 35 983 (of original 36 282) women aged 50 to 79 years old in the Women's Health Initiative randomized trial of CaD supplementation who were randomized 1:1 in a double-blinded fashion to receive 1000 mg/d of calcium plus 400 IU/d of vitamin D<sub>3</sub> or placebo. Overall, 744 adjudicated incident HF cases (intervention, 363; control, 381) occurred during a median follow-up of 7.1 (interquartile range, 1.6) years. CaD supplementation, compared with placebo, was not associated with reduced HF risk in the overall population, hazard ratio, 0.95; <italic>P</italic>=0.46. However, CaD supplementation had differential effects (<italic>P</italic> interaction=0.005) in subgroups stratified by baseline risk status of HF defined by the presence (high risk=17 449) or absence (low risk=18 534) of pre-existing HF precursors including coronary heart diseases, diabetes mellitus, or hypertension: 37% (hazard ratio, 0.63 [95% confidence interval, 0.46–0.87]) lower risk of HF in the low-risk versus hazard ratio, 1.06; <italic>P</italic>=0.51, in the high-risk subgroups.</p> </sec> <sec> <title>Conclusions—</title> <p>CaD supplementation did not significantly reduce HF incidence in the overall cohort, however, it was beneficial among postmenopausal women without major HF precursors while of little value in high-risk subgroups. Additional studies are warranted to confirm these findings and investigate the underlying mechanism.</p> </sec> <sec> <title>Clinical Trial Registration—</title> <p>URL: <ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov" xlink:type="simple" xmlns:xlink="http://www.w3.org/1999/xlink">http://www.clinicaltrials.gov</ext-link>. Unique identifier: NCT00000611.</p> </sec> </abstract>