Does vitamin D cause heart attacks?

Q. I get a health newsletter from a respected medical center. I noticed in the last issue that vitamin D could raise the risk of heart attack and stroke by up to 20 percent. Any comments?

A. Several research reports have created considerable confusion. A year ago, researchers reported that people taking calcium supplements were 30 percent more likely to have a heart attack than those getting placebos (BMJ online, July 29, 2010). Although this finding came from a meta-analysis of 11 studies involving more than 12,000 people, many health professionals were skeptical and objected that vitamin D intake was not part of the analysis.

This year, a new study in BMJ (online, April 19, 2011) confirmed the original finding with a twist. Even women taking vitamin D with their calcium had a higher risk of heart attack or stroke compared with placebo. We suspect that this is what your newsletter was reporting.

More recent research shows that vitamin D alone appears to protect men from heart attacks and strokes (American Journal of Clinical Nutrition online, June 8, 2011).

For more on the benefits and risks of vitamin D, you may wish to review our Guide to Vitamin D Deficiency. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (64 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. D-23, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

Excess calcium may be the culprit, while vitamin D may be neutral or protective for the heart.

Q. I am a 66-year-old retired physician who has taken simvastatin for the past two years. During this time, I noted a gradual decline in my erectile function. My physician did not believe that simvastatin was the cause. After reading in The People’s Pharmacy and elsewhere of a possible connection, I took myself off the drug. Within three weeks, I had complete resolution of my problem.

A. There is surprisingly little research on this topic. Although the official prescribing information for simvastatin (Zocor) mentions erectile dysfunction, many physicians have not heard about this link. One study suggested that statins may cause or worsen erectile dysfunction (Drug Safety, July 2009). Italian researchers have reported that statins may reduce testosterone levels (Journal of Sexual Medicine, April 2010).

Q. After installing a stent near my heart, my doctor said no changes were needed in my list of medications, even though I would be mixing Nexium with Plavix. I checked this advice online and saw another specialist. He immediately stopped the Nexium and changed my GERD medication to pantoprazole.

A. There is uncertainty about the interaction between acid-suppressing drugs like esomeprazole (Nexium) and the anti- clotting drug clopidogrel (Plavix) that you need to keep your stent open. Some studies suggest that the acid-suppressor will interfere with the effectiveness of Plavix or even aspirin. Pantoprazole (Protonix) appears to be the best choice if a GERD (gastroesophageal reflux disease) medicine is needed (Thrombosis and Haemostasis, June 2011).

2011 King Features Syndicate, Inc.