Effects of Vitamin D and Omega 3 Fatty Acids on Incidence Rate of Heart Failure

摘要 心力衰竭（HF）的支出每年高达数十亿美元。尽管医学治疗取得了进步， HF、HF发作后的死亡率和HF失代偿复发率仍然很高，强调迫切需要 需要确定有效的预防战略。观察性研究显示HF患者的死亡风险较高 维生素D水平较低的患者，以及最近对大多数患者进行的试验进行的两项事后分析， 绝经期妇女报告说，与安慰剂组相比，维生素D组的HF发生率降低。维生素D 据报道，在229名HF患者中，也可改善血液动力学和左心室重塑。然而，在这方面， 没有随机试验研究维生素D对HF一级预防的影响或对HF发生率的影响。 男性和女性的复发性HF失代偿。二十碳五烯酸（EPA）和 二十二碳六烯酸（DHA）对心血管事件的影响已在试验中报告， 仅使用。EPA/DHA可以减少HF的危险因素，包括心肌梗死、高血压和糖尿病。 虽然一些但不是所有的观察性研究都表明EPA/DHA与 HF的发病率，没有进行EPA/DHA对HF的大型一级预防试验。此外，本发明还提供了一种方法， 他汀类药物对EPA/DHA对HF的影响的影响修饰尚未阐明。该项目将 研究维生素D和EPA/DHA补充剂对HF发病率和复发率的影响。 一项由NIH资助的维生素D和OmegA-3 TriaL（VITAL）辅助研究中的HF失代偿 25,874名男性和女性的随机对照试验，测试2,000 IU/天胆钙化醇和1 g/day EPA/DHA对心血管疾病和癌症终点的影响。

Abstract Heart failure (HF) expenditure amounts to several billion per year. Despite advances in medical treatment of HF, mortality after HF onset and rate of recurrent HF decompensation remain high, underscoring an urgent need to identify effective prevention strategies. Observational studies showed a higher risk of death in HF patients with lower levels of vitamin D and two recent post-hoc analyses of trials conducted in mostly post- menopausal women reported a reduction in HF rates in the vitamin D group compared with placebo. Vitamin D has also been reported to improve hemodynamics and left ventricular remodeling in 229 HF patients. However, no randomized trial has examined the effects of vitamin D on primary prevention of HF or on the rate of recurrent HF decompensation in men and women. Efficacy of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on cardiovascular events has been reported in trials with low prevalence of stain use only. EPA/DHA can reduce risk factors for HF including myocardial infarction, hypertension, and diabetes. While some but not all observational studies have suggested an inverse association between EPA/DHA and the incidence of HF, no large primary prevention trial of EPA/DHA on HF has been conducted. In addition, effect modification of the effects of EPA/DHA on HF by statin has not been elucidated. This project will investigate the effects of vitamin D and EPA/DHA supplements on the incidence rate of HF and on recurrent HF decompensation in an ancillary study of the VITamin D and OmegA-3 TriaL (VITAL), an NIH-funded randomized controlled trial of 25,874 men and women testing the efficacy of 2,000 IU/day cholecalciferol and 1 g/day EPA/DHA on cardiovascular disease and cancer endpoints.