Abstract
Background: Depressive symptoms and vitamin D deficiency predict cardiac events in heart failure patients, but whether vitamin D supplements are associated with depressive symptoms and cardiac events in heart failure patients remains unknown. Purpose: The purpose of this study was to compare the association of vitamin D supplement use with depressive symptoms and cardiac events in heart failure patients with mild or moderate to severe depressive symptoms. Methods: A total of 177 heart failure patients with depressive symptoms (Patient Health Questionnaire-9 score ≥5) completed a three-day food diary to determine dietary vitamin D deficiency. Patients were split into four groups by dietary vitamin D adequacy versus deficiency and vitamin D supplement use versus non-use. The Patient Health Questionnaire-9 was used to reassess depressive symptoms at six months. Data on cardiac events for up to one year and vitamin D supplement use were obtained from patient interview and medical record review. Hierarchical linear and Cox regressions were used for data analysis. Results: Sixty-six patients (37.3%) had dietary vitamin D deficiency and 80 (45.2%) used vitamin D supplements. In patients with moderate to severe depressive symptoms, the group with dietary vitamin D deficiency and no supplements had the highest Patient Health Questionnaire-9 score at six months (β=0.542, p<0.001) and shortest cardiac event-free survival (p<0.001) among the four groups, the group with dietary vitamin D deficiency and no supplements didn’t have the highest Patient Health Questionnaire-9 score at six months and shortest cardiac event-free survival in patients with mild depressive symptoms. Conclusions: Vitamin D supplements predicted lower depressive symptoms and reduced cardiac events for patients with moderate to severe depressive symptoms. Vitamin D deficiency was associated with higher risk of shorter cardiac event-free survival in heart failure patients regardless of vitamin D supplementation.
Original language | English |
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Pages (from-to) | 207-216 |
Number of pages | 10 |
Journal | European Journal of Cardiovascular Nursing |
Volume | 17 |
Issue number | 3 |
DOIs | |
State | Published - Mar 1 2018 |
Bibliographical note
Funding Information:This work was supported by a grant, NRF-2015R1D1A1A01059392 from the National Research Foundation (NRF) of Korea.
Publisher Copyright:
© 2017, © The European Society of Cardiology 2017.
Keywords
- Heart failure
- depression
- supplement
- survival
- vitamin D
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- MedicalSurgical
- Advanced and Specialized Nursing