New Study Ties Increased Vitamin K Intake to Lower ASCVD Risk

Nicola Bondonno, PhD

An analysis of dietary patterns from more than 50,000 patients suggests diets high in vitamin K could reduce a patient’s risk of developing atherosclerotic cardiovascular disease (ASCVD), with an even more noteworthy effect on risk of peripheral artery disease (PAD).

Leveraging food frequency questionnaire data from the Danish Diet, Cancer, and Health Study, investigators found patients with the greatest levels of vitamin K₁ and vitamin K₂ intake experienced a 21% and 14%, respectively, lower risk of experiencing an ASCVD-related hospitalization during the study.

“Current dietary guidelines for the consumption of vitamin K are generally only based on the amount of vitamin K₁ a person should consume to ensure that their blood can coagulate,” said Nicola Bondonno, PhD, research fellow and adjunct lecturer at Edith Cowan University, in a statement. “However, there is growing evidence that intakes of vitamin K above the current guidelines can afford further protection against the development of other diseases, such as atherosclerosis.”

With an interest in understanding the impact of vitamin K intake on incident ASCVD, Bondonno and colleagues from Edith Cowan University sought to describe potential associations through an analysis of data from the Danish Diet, Cancer, and Health Study, which was a prospective cohort study enrolling more than 57000 patients between 1993-1997 who were followed through 2016. Using data from food frequency questionnaires administered at baseline linked with national health records, investigators designed their study to assess associations between vitamin K intake and incident ASCVD hospitalizations.

Of the 57,053 participants enrolled in the Danish Diet, Cancer, and Health study, 56,468 completed a food frequency questionnaire at baseline. After exclusion of those with missing covariate information and those with history of cancer or ASCVD at baseline, investigators identified a cohort of 53,372 participants for inclusion in their analyses.

The study cohort had a median age of 56 (IQR, 52-60) years at entry and a median follow-up of 21 (IQR, 17-22) years. For the purpose of analysis, patients were categorized into quintiles of intake of both vitamin K1 and vitamin K2. During the 944,247 person-years of follow-up, 8726 participants were hospitalized for ASCVD, including 5290 for ischemic heart disease (IHD), 2913 for ischemic stroke, and 1856 for PAD.

In multivariable-adjusted analysis, participants in the highest quintile of vitamin K₁ intake had a 21% lower risk of an ASCVD-related hospitalization than those in the lowest quintile (HR, 0.79; 95% CI, 0.74-0.84). Investigators pointed out greater intake of vitamin K₁ was a 14% lower risk of a hospitalization for IHD (HR, 0.86; 95% CI, 0.80–0.93), a 17% lower risk of hospitalization for an ischemic stroke (HR, 0.83; 95% CI, 0.75–0.91), and a 34% lower risk of a PAD‐related hospitalization (HR, 0.66; 95% CI, 0.58–0.75).

For vitamin K₂, investigators found those in the highest quintile of intake had a 14% lower risk of ASCVD-related hospitalization (HR, 0.86; 95% CI, 0.81-0.91). Investigators pointed out greater intake of vitamin K₂ was linked to a 14% lower risk of hospitalization for IHD (HR, 0.86; 95% CI, 0.80–0.92), a 13% lower risk of hospitalization for ischemic stroke (HR, 0.87; 95% CI, 0.79–0.95), and a 12% lower risk of a PAD‐related hospitalization (HR, 0.88; 95% CI, 0.78–0.99).

“Although more research is needed to fully understand the process, we believe that vitamin K works by protecting against the calcium build-up in the major arteries of the body leading to vascular calcification,” Bondonno added.

This study, “Vitamin K Intake and Atherosclerotic Cardiovascular Disease in the Danish Diet Cancer and Health Study,” was published in the Journal of the American Heart Association.