The Effects of Vitamin D Supplementation on Physical Function and Quality of Life in Older Heart Failure Patients: A Randomised Controlled Trial

Background —Low 25 hydroxyvitamin D levels, commonly found in older heart failure patients, may contribute to the chronic inflammation and skeletal myopathy that lead to poor exercise tolerance. We tested whether vitamin D supplementation of patients with heart failure and vitamin D insufficiency can improve physical function and quality of life Methods and Results —Randomised, parallel group, double blind, placebo controlled trial. Systolic heart failure patients aged 70 or over with 25-hydroxyvitamin D levels <50nmol/L (20ng/ml) received 100,000 units of oral vitamin D2 or placebo at baseline and 10 weeks. Outcomes measured at baseline, 10 weeks and 20 weeks were six minute walk distance, quality of life (Minnesota score), daily activity measured by accelerometry, Functional Limitations Profile, B-type natriuretic peptide and tumor necrosis factor alpha. Participants in the vitamin D group increased their 25 hydroxyvitamin D levels compared to placebo at 10 weeks (22.9 vs 2.3 nmol/L [9.2 vs 0.9 ng/ml], p<0.001), and maintained this increase at 20 weeks. The six minute walk did not improve in the treatment group relative to placebo. No significant benefit was seen on timed up and go testing, subjective measures of function, daily activity or tumor necrosis factor. Quality of life worsened by a small but significant amount in the treatment group relative to placebo. B-type natriuretic peptide declined in the treatment group relative to placebo (-22 vs +78 pg/ml at 10 weeks, p=0.04). Conclusions —Vitamin D supplementation did not improve functional capacity or quality of life in older heart failure patients with vitamin D insufficiency. Clinical Trial Registration Information —URL: http://www.controlled-trials.com. Identifier: ISRCTN51372896