Vitamin K insufficiency linked to cardiovascular disease and mortality

By:  Dr. Manfred Eggersdorfer, Professor of Healthy Ageing at the University Medical Center Groningen

Summary

• Cardiovascular health remains a growing global concern among consumers. 
• A new study has highlighted a link between vitamin K blood status and heart health, revealing that vitamin K levels were lower in those with cardiovascular disease (CVD) and other heart related comorbidities, such as hypertension and type 2 diabetes.¹ 
• It also found that vitamin K insufficiency is strongly linked to cardiovascular mortality. This reinforces the importance of dietary supplementation, especially with the rapidly aging population and rising prevalence of lifestyle related diseases viewed as CVD risks. 

Vitamin K’s link to heart health is less established than other key nutrients such as omega-3s and vitamins C, D and E. However, a new study has shown that vitamin K insufficiency is significantly higher in people with cardiovascular disease, and also strongly linked to increased risk of cardiovascular mortality. This highlights the need for better awareness of vitamin K cardioprotective benefits, as well as increased consumption via dietary supplements.

Heart disease – a growing health concern 

CVD continues to be one of the biggest threats to human health across the world. An estimated 17.7 million people currently die from CVDs each year, representing 31% of all global deaths.² As a result of the aging population and rising prevalence of lifestyle related diseases such as type 2 diabetes and hypertension, it is estimated that more than 40% of the US population will have some form of CVD by 2030.3 This is expected to have a major impact for individuals and also put huge pressures on healthcare systems and the society.

Vitamin K – should we be paying more attention?

Extensive scientific research has already revealed the positive effects of key nutrients such as omega-3 fatty acids, and vitamins C, D and E on heart health and reduced CVD risk. Despite the fact that vitamin K plays an important role in the blood clotting process, there has been less emphasis to date on its cardioprotective benefits and little data indicating the prevalence of vitamin K insufficiency in the general population.

A link to CVD  

A new study, which included 4,275 people from the Prevention of Renal and Vascular End-Stage Disease (PREVEND) cohort, aimed to evaluate the prevalence of vitamin K deficiency using plasma desphospho-uncarboxylated MGP (dp-ucMGP) as a marker. Matrix Gla Protein (MGP) is a strong vitamin K-dependent inhibitor of soft tissue calcification with high dp-ucMGP plasma levels (concentrations above 500 pmol/L) indicative of vitamin K insufficiency.⁴ The report found that 31% of the population surveyed had dp-ucMGP plasma levels above the defined concentration and were therefore considered vitamin K insufficient. Furthermore, the prevalence of vitamin K insufficiency was significantly higher among elderly subjects and those with comorbidities such as hypertension, type 2 diabetes, chronic kidney disease and cardiovascular disease (~50%). Prevalence increased again in subjects who had a number of comorbidities. These findings indicate a potential correlation between vitamin K status and heart disease.  

Vitamin K deficiency and mortality

n addition to this, the authors assessed whether vitamin K insufficiency was associated with cardiovascular mortality. After a 10 year follow up, 74 subjects (1.7%) had died as a result of cardiovascular-related issues. Results showed that plasma dp-ucMGP levels were significantly associated with all-cause mortality and cardiovascular mortality, suggesting vitamin K insufficiency is strongly linked to deaths caused by heart disease. 

Based on the study results, the authors also specified a cut-off value for dp-ucMGP to help identify subjects at risk of cardiovascular mortality. The cut-off values were defined as 414 pmol/L for risks for all-cause mortality and 557 pmol/L for cardiovascular mortality, with anything above these levels associated with increased risk of death. 

These results are encouraging however, further research is needed in human intervention studies to demonstrate that increased intake of vitamin K allows us to meet the recommended daily intake therefore improving heart health.

Vitamin K intake

High plasma dp-ucMGP levels may reflect a low dietary intake of vitamin K, contributing to vitamin K insufficiency. Currently, the recommended intake of vitamin K is 90 µg/day for women and 120 µg/day for men.⁵ However, similar to the results observed in the study above, a previous report showed that vitamin K status was lower than recommended in 20% of women and 40% of men.⁶

To reduce the foreseeable burden on the healthcare system as a result of vitamin K insufficiency, making education available to the general population is paramount. With the rapidly aging population and rising prevalence of lifestyle related diseases and CVD risks, such as type 2 diabetes and hypertension, these latest findings reinforce the importance and benefit of vitamin K dietary supplementation.