Article Figures & Data
Figures
- Figure 1.
Adjusted incidence rate ratio (IRR) for quartiles of plasma 25(OH)D levels with lowest quartile as reference (IRR = 1).
25(OH)D = 25, hydroxyvitamin D.
Tables
- Table 1.
Distribution of Characteristics (Means, Proportions) by Quartiles of Plasma 25(OH)D
Quartiles of 25(OH)D Characteristics Overall Mean or Proportiona <25th 25–49th 50–74th 75–100th ACR=albumin-creatinine ratio; BMI=body mass index; BP=blood pressure; CV=cardiovascular; 25(OH)D=25, hydroxyvitamin D; eGFR=estimated glomerular filtration rate; MET = metabolic equivalent task. Note: Values are weighted to produce national estimates. a Numbers are proportions except where indicated as means. 25(OH)D, range, ng/mL <18 18–24.9 25–31.9 >32 25(OH)D, mean, ng/mL 29.64 13.90 21.60 28.44 41.63 Age, mean, y 43.64 45.55 45.83 44.53 40.89 Male 0.48 0.34 0.44 0.49 0.55 Race/ethnicity White 0.77 0.48 0.68 0.82 0.91 Black 0.10 0.33 0.13 0.06 0.02 Hispanic 0.09 0.13 0.13 0.10 0.06 Other 0.03 0.06 0.05 0.03 0.01 Poverty level <100% 0.12 0.18 0.13 0.11 0.09 100%–150% 0.10 0.12 0.11 0.08 0.09 150%–200% 0.13 0.14 0.13 0.12 0.13 200%–300% 0.23 0.21 0.23 0.23 0.23 >300% 0.43 0.35 0.40 0.46 0.46 Current smoker 0.28 0.32 0.27 0.26 0.29 Exercise, METs <3.5/mo 0.17 0.31 0.21 0.16 0.10 BMI, mean, kg/m2 26.43 28.00 27.42 26.37 25.25 Systolic BP, mean, mm Hg 121.98 124.31 123.58 122.08 119.77 Total cholesterol, mean, mg/dL 202.96 204.32 206.00 201.64 201.42 Serum albumin, mean, mg/dL 4.19 4.09 4.15 4.21 4.24 C-reactive protein, mean, mg/L 0.41 0.49 0.42 0.42 0.36 eGFR, mean, mL/min per 1.73 m2 93.72 98.77 93.32 93.42 92.24 Urinary ACR, mean 0.25 0.48 0.24 0.21 0.18 Self-rated health Excellent 0.20 0.15 0.18 0.21 0.23 Very good 0.32 0.24 0.28 0.33 0.36 Good 0.33 0.39 0.35 0.32 0.30 Fair 0.13 0.17 0.16 0.12 0.09 Poor 0.03 0.04 0.03 0.02 0.02 Diabetes 0.10 0.17 0.12 0.10 0.07 Baseline CV morbidity 0.03 0.04 0.04 0.03 0.03 Chronic kidney disease 0.05 0.06 0.06 0.05 0.04 - Table 2.
Adjusted Incident Rate Ratio (IRR) For Death From Cardiovascular Disease During Follow-Up Interval
Characteristic IRR 95% CI BMI=body mass index; CI=confidence interval; 25(OH)D = 25, hydroxyvitamin D; eGFR=estimated glomerular filtration rate; MET = metabolic equivalency task. Note: IRRs are based on a fully adjusted model including all variables in table, month of baseline evaluation, and region. 25(OH)D quartiles (reference <25th quartile) 25–49th 0.71 0.54–0.94 50–74th 0.65 0.53–0.79 ≥75th 0.79 0.62–1.01 Age, years 1.15 1.11–1.18 Log (age) 0.04 0.01–0.20 Male 2.38 1.92–2.96 Race/ethnicity (reference white) Black 0.81 0.65–1.01 Hispanic 0.53 0.37–0.76 Other 0.83 0.33–2.04 Poverty level (reference <100% poverty level) 100%–149% 0.95 0.66–1.37 150%–199% 0.99 0.73–1.36 200%–299% 0.93 0.71–1.23 ≥300% 0.82 0.59–1.13 Current smoker 1.55 1.25–1.92 No exercise (METs <3.5/mo) 1.29 1.04–1.59 BMI category (reference <20 kg/m2) 20.0–24.9 kg/m2 0.64 0.45–0.91 25.0–29.9 kg/m2 0.62 0.46–0.83 ≥30.0 kg/m2 0.63 0.41–0.97 Systolic blood pressure (reference <120 mm Hg) 120–139 mm Hg 1.38 1.01–1.89 >140 mm Hg 1.40 1.02–1.91 Total cholesterol (reference <200 mg/mL) 200–239 mg/mL 1.04 0.80–1.34 240–279 mg/mL 1.37 1.10–1.70 ≥280 mg/mL 1.12 0.86–1.45 Serum albumin, mg/dL 0.80 0.55–1.17 Log (C-reactive protein) 1.14 1.02–1.26 eGFR, mL/min per 1.73 m2 0.99 0.98–1.00 Log (urinary albumin-creatinine ratio) 1.24 1.16–1.33 Self-rated health (reference excellent) Very good 1.22 0.89–1.66 Good 1.37 0.97–1.92 Fair 1.70 1.09–2.65 Poor 2.49 1.63–3.80 Diabetes 1.24 1.00–1.53 Baseline cardiovascular morbidity 2.08 1.68–2.58 Chronic kidney disease 1.05 0.79–1.40 - Table 3.
Incident Rate Ratios (IRR) For Death From Cardiovascular Disease During Follow-up Interval With Selected Adjustment
IRR 95% CI 25(OH)D=25, hydroxyvitamin D. Note: All models adjusted for age, log (age), sex, region, and month of baseline evaluation. Model 1 adjusts for race, model 2 adjusts for race and serum 25(OH)D (lowest quartile vs others), model 3 adjusts for race and poverty level, and model 4 adjusts for race, poverty level, and serum 25(OH)D. Model 1 Race (reference white) Black 1.38 1.13–1.70 Model 2 Race (reference white) Black 1.14 0.91–1.44 25(OH)D quartile (reference highest quartile) Low 25(OH)D 1.73 1.44–2.09 Model 3 Race (reference white) Black 1.20 0.99–1.46 Poverty level (reference <100%) 100%–149% 0.96 0.69–1.34 150%–199% 1.03 0.74–1.43 200%–299% 0.69 0.54–0.88 >300% 0.55 0.43–0.71 Model 4 Race (reference white) Black 1.01 0.82–1.24 Poverty level (reference <100%) 100%–149% 0.98 0.70–1.37 150%–199% 1.05 0.75–1.46 200%–299% 0.72 0.56–0.91 >300% 0.56 0.44–0.73 25(OH)D (reference highest quartile) Low 25(OH)D 1.70 1.43–2.03
Supplemental Appendix
Supplemental Appendix. Details on Measures
Files in this Data Supplement:
- Supplemental data: Appendix - PDF file, 2 pages, 125 KB
The Article in Brief
Vitamin D, Race, and Cardiovascular Mortality: Findings From a National US Sample
Kevin Fiscella , and colleagues
Background Low levels of vitamin D have been linked to cardiovascular disease. This study examines whether low vitamin D levels predict cardiovascular mortality among US adults and whether differences in vitamin D levels contribute to black-white differences in cardiovascular mortality after adjustments for age and sex.
What This Study Found Low levels of vitamin D are associated with increased cardiovascular mortality in a nationally representative US sample. Higher cardiovascular risk among blacks is partly related to lower vitamin D levels as a result of decreased sun exposure and absorption, higher dermal melanin, and lower vitamin D intake.
Implications
- The authors call for further research to determine whether vitamin D supplementation might improve cardiovascular outcomes and existing health disparities.
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