Vitamin K Intake and Atherosclerotic Cardiovascular Disease in the Danish Diet Cancer and Health Study

Abstract

Background Dietary vitamin K (K 1 and K 2 ) may reduce atherosclerotic cardiovascular disease (ASCVD) risk via several mechanisms. However, studies linking vitamin K intake with incident ASCVD are limited. We aimed to determine the relationship between dietary vitamin K intake and ASCVD hospitalizations. Methods and Results In this prospective cohort study, participants from the Danish Diet, Cancer, and Health Study, with no prior ASCVD, completed a food‐frequency questionnaire at baseline and were followed up for hospital admissions of ASCVD; ischemic heart disease, ischemic stroke, or peripheral artery disease. Intakes of vitamin K 1 and vitamin K 2 were estimated from the food‐frequency questionnaire, and their relationship with ASCVD hospitalizations was determined using Cox proportional hazards models. Among 53 372 Danish citizens with a median (interquartile range) age of 56 (52–60) years, 8726 individuals were hospitalized for any ASCVD during 21 (17–22) years of follow‐up. Compared with participants with the lowest vitamin K 1 intakes, participants with the highest intakes had a 21% lower risk of an ASCVD‐related hospitalization (hazard ratio, 0.79; 95% CI: 0.74–0.84), after multivariable adjustments for relevant demographic covariates. Likewise for vitamin K 2 , the risk of an ASCVD‐related hospitalization for participants with the highest intakes was 14% lower than participants with the lowest vitamin K 2 intake (hazard ratio, 0.86; 95% CI, 0.81–0.91). Conclusions Risk of ASCVD was inversely associated with diets high in vitamin K 1 or K 2 . The similar inverse associations with both vitamin K 1 and K 2 , despite very different dietary sources, highlight the potential importance of vitamin K for ASCVD prevention.

Association between vitamin K1 intake and mortality in the Danish Diet, Cancer, and Health cohort

“…In the present study, higher vitamin K 1 intakes were associated with a lower risk of CVD-related mortality. Interestingly, we have reported previously in this cohort [ 22 ] that higher vitamin K 1 intakes were independently associated with a 21% lower risk of an atherosclerotic CVD-related hospitalisation [multivariable adjusted HR for highest compared to lowest intakes: 0.79, 95% CI (0.74, 0.84)].…”

“…The FFQ asked participants to indicate their usual frequency of intake of different food and beverage items over the previous 12 months, using a 12-category frequency scale that ranged from never to eight times or more per day [ 17 ]. The intake of dietary vitamin K 1 was estimated by multiplying the food/beverage item consumed (g/d) by the mean vitamin K 1 value (μg/g) obtained from the Frida Food Data database [ 20 ] and, when a value was not available, the United States Department of Agriculture (USDA) database [ 21 ], as described previously [ 22 ].…”

Inflammation-mediated vitamin K and vitamin D effects on vascular calcifications in people with HIV on active antiretroviral therapy

“…The association of vitamin K status and progression of atherosclerosis and calcifications was described in the study by Kurnatowska et al [35], where they noted a 270-day course of vitamin K administration reduced the progression of atherosclerosis with a lower rate of increase in carotid intima–media thickness (0.95 ± 0.2 to 1.01 ± 0.3 P = 0.003 from 1.02 ± 0.2 mm to 1.16 ± 0.3, P = 0.003). This was furthered by Bellinge et al [36] who demonstrated in their prospective cohort study that individuals with the highest vitamin K intakes compared with individuals with the lowest intake, had a 21% lower risk of ASCVD-related hospitalizations (hazard ratio 0.79; 95% CI 0.74–0.84). Vitamin K supplementation, therefore, may be a potential target for combating inflammation and decreasing cardiovascular outcomes in the general population [37].…”

Vitamin K Supplementation for Prevention of Vascular Calcification in Chronic Kidney Disease Patients: Are We There Yet?

“…Epidemiological data in the general population (NHANES II [ 58 ]) as well as ERGO [ 59 ], the Danish Diet, Cancer and Health Study [ 60 ], EPIC [ 61 ], and the PREVEND study [ 62 ] have all suggested that poor vitamin K status is independently associated with VC, mortality, and CV disease. Subclinical vitamin K depletion is highly prevalent in ESKD patients and has been associated with VC, vascular stiffness, mortality, and CV disease.…”