Vitamin D and cardiovascular outcomes in multiple sclerosis

Area of Science:

• Neurology
• Endocrinology
• Cardiology

Background:

• Vitamin D (25(OH)D) deficiency is a known risk factor for cardiovascular disease (CVD) in the general population.
• The association between 25(OH)D levels and CVD outcomes in people with multiple sclerosis (pwMS) has not been previously explored.

Purpose of the Study:

• To investigate the relationship between 25(OH)D levels and long-term CVD outcomes in pwMS.
• To assess the impact of vitamin D supplementation on CVD risk in this population.

Main Methods:

• An observational cohort study utilized anonymized medical records from 70 healthcare organizations, following pwMS for 5 years (2019-2024).
• Propensity-score matching (1:1) was employed to compare pwMS with deficient/inadequate 25(OH)D levels to those with adequate levels, controlling for demographics, comorbidities, and cardiovascular care.
• Cox proportional hazard models were used to analyze the incidence of major adverse cardiovascular events (MACE), including mortality, stroke, myocardial infarction, heart failure, angina, and atrial fibrillation/flutter.

Main Results:

• Of 74,372 pwMS, 9% had deficient, 18% inadequate, and 73% adequate 25(OH)D levels.
• Deficient and inadequate 25(OH)D levels were associated with a significantly increased rate of MACE (HR 1.32 and 1.29, respectively) compared to adequate levels.
• Cholecalciferol supplementation in pwMS with deficient or inadequate 25(OH)D levels did not mitigate the elevated CVD risk compared to those with adequate levels not taking supplementation.

Conclusions:

• Deficient or inadequate 25(OH)D levels in pwMS are associated with an increased risk of MACE.
• Vitamin D supplementation (cholecalciferol) may not effectively reduce the heightened CVD risk in pwMS with low 25(OH)D levels.