Dietary Supplements

Effect of Vitamin D Supplementation on Cardiometabolic Outcomes in Older Australian Adults-Results from the Randomized Controlled D-Health Trial.

TL;DR

Monthly supplements of vitamin D did not alter the incidence of hypertension, hypercholesterolemia, or type 2 diabetes in older, largely vitamin D-replete Australians.

Key Findings

Vitamin D supplementation had no material effect on the incidence of hypertension in older Australian adults.

  • HR 1.00; 95% CI 0.93 to 1.08
  • Analysis included 10,964 participants (vitamin D, n = 5456 [49.8%]; placebo, n = 5508 [50.2%])
  • 2672 participants (24.4%) developed hypertension over a median follow-up of 4.6 years
  • Incident hypertension was defined as commencing treatment with anti-hypertensive drugs, ascertained via linkage with the Australian Pharmaceutical Benefits Scheme database

Vitamin D supplementation had no material effect on the incidence of hypercholesterolemia in older Australian adults.

  • HR 1.05; 95% CI 0.97 to 1.13
  • Analysis included 12,126 participants (vitamin D, n = 6038 [49.8%]; placebo, n = 6088 [50.2%])
  • 2554 participants (21.1%) developed hypercholesterolemia over a median follow-up of 4.6 years
  • Incident hypercholesterolemia was defined as commencing treatment with lipid-modifying drugs

Vitamin D supplementation had no material effect on the incidence of type 2 diabetes in older Australian adults.

  • HR 0.97; 95% CI 0.84 to 1.12
  • Analysis included 17,846 participants (vitamin D, n = 8931 [50.0%]; placebo, n = 8915 [50.0%])
  • 779 participants (4.4%) developed type 2 diabetes over a median follow-up of 4.6 years
  • Incident T2D was defined as commencing treatment with anti-diabetic drugs

The D-Health Trial was a large randomized, double-blind, placebo-controlled trial of monthly high-dose vitamin D3 supplementation in older Australians.

  • Total enrollment was N = 21,315 participants aged 60-84 years
  • Intervention consisted of monthly doses of 60,000 international units of oral vitamin D3
  • Follow-up began 6 months after randomization
  • Outcomes were ascertained via linkage with the Australian Pharmaceutical Benefits Scheme database
  • Flexible parametric survival models were used to estimate the effect of vitamin D supplementation on each outcome

Observational studies have found inverse associations between 25-hydroxyvitamin D concentration and risk of hypertension, hypercholesterolemia, and type 2 diabetes, but evidence from large-scale randomized controlled trials has been limited or inconclusive.

  • The study population was described as largely vitamin D-replete Australians
  • Participants were excluded if they lacked linked pharmaceutical data, were prevalent cases, or died prior to start of follow-up
  • The study used drug initiation as a surrogate endpoint for incident cardiometabolic conditions

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Citation

Duarte Romero B, Armstrong B, Baxter C, English D, Ebeling P, Hartel G, et al.. (2026). Effect of Vitamin D Supplementation on Cardiometabolic Outcomes in Older Australian Adults-Results from the Randomized Controlled D-Health Trial.. Nutrients. https://doi.org/10.3390/nu18020357