Vitamin D deficiency may contribute to a higher number of heart and stroke-related deaths among black Americans compared to whites, according to a University of Rochester Medical Center study.
The journal Annals of Family Medicine is publishing the study in the January-February edition, which goes online Jan. 11, 2010.
Researchers sought to understand the well-documented disparity between blacks and whites in cardiovascular deaths. They turned to vitamin D because growing evidence links low serum levels of D to many serious illnesses including diabetes, hypertension, kidney and heart disease.
Lead author Kevin Fiscella, M.D., said a complex host of genetic and lifestyle factors among blacks may explain why this population group has lower vitamin D levels across the lifespan than other races.
People get vitamin D through their diets, sun exposure, and oral supplements. Genetic factors common to blacks sometimes preclude vitamin D absorption, such as a higher incidence of lactose intolerance, which can eliminate vitamin-D fortified milk from the diet, and darker skin pigment that significantly reduces vitamin D synthesis.
"Therefore, our study suggests that the next step would be to intervene to boost vitamin D levels safely, with supplements," said Fiscella, a national expert on disparities in health care and a professor of Family Medicine and Community and Preventive Medicine at URMC.
With funding through The National Heart Lung and Blood Institute, Fiscella and colleagues studied a sample of more than 15,000 American adults. The data included measurements of blood levels of vitamin D and death rates due to cardiovascular disease. Researchers also looked at other factors that contribute to heart health, such as body mass index, smoking status and levels of C-reactive protein.
Overall, the analysis showed that, as expected, a vitamin D deficiency was associated with higher rates of death among all people in the sample. In fact, those adults with the worst deficiency had a 40 percent higher risk of death from cardiac illness. This suggests that vitamin D may be a modifiable, independent risk factor for heart disease, Fiscella said.
Most striking, however, was that when researchers adjusted the statistics to look at race, blacks had a 38 percent higher risk of death than whites. As vitamin D levels rose, however, the risk of death was reduced. The same was true when researchers analyzed the effect of poverty on cardiovascular death rates among blacks, which suggests that vitamin D deficiency and poverty each exert separate risk factors, the study said.
A review article published in September 2009 in The American Journal of Medicine, noted that Vitamin D deficiency is a worldwide health problem. In the U.S., inadequate Vitamin D has been reported in about 36 percent of otherwise healthy young adults and about 57 percent of general medicine hospitalized patients.