Summary: In the large D-Health trial of older Australians, monthly 60,000 IU vitamin D3 over a median 4.6 years did not reduce the incidence of hypertension, hypercholesterolaemia, or type 2 diabetes in a largely vitamin D-replete population.
PICO Summary
| Element | Detail |
|---|---|
| Population | Community-dwelling Australians aged 60–84, mostly vitamin D-replete (D-Health Trial; 10,964–17,846 analysed per outcome). |
| Intervention | Monthly oral vitamin D3 60,000 IU. |
| Comparison | Placebo. |
| Outcome | No effect over a median 4.6 years on new hypertension (HR 1.00; 95% CI 0.93–1.08), hypercholesterolaemia (HR 1.05; 0.97–1.13), or type 2 diabetes (HR 0.97; 0.84–1.12), using initiation of relevant drug therapy as the surrogate. |
Vitamin D and Cardiometabolic Disease (D-Health)
RCT · older adults · median 4.6 years
Monthly vitamin D3 did not lower the incidence of hypertension, high cholesterol, or type 2 diabetes in mostly vitamin D-replete older adults. All three hazard ratios sat on or near 1.0 with tight confidence intervals.
Expert Commentary
Observational data have long tied low vitamin D to hypertension, dyslipidaemia, and diabetes, and this trial is exactly the kind of large, well-powered randomised test needed to see whether that association is causal or merely a marker of poor health. The verdict is unambiguously negative, and I find it persuasive precisely because of its scale and the tightness of the confidence intervals: three hazard ratios sitting on or near 1.0 with narrow bounds is not an underpowered miss, it is a real absence of effect. The crucial interpretive point is the population, which was largely vitamin D-replete to begin with, so this tells me supplementing people who are not deficient does not prevent cardiometabolic disease. It leaves the genuinely deficient as a separate question. Using drug initiation as a surrogate for incident disease is a fair pragmatic choice with linked pharmacy data. Can I use this with my patients? Yes, as a deprescribing and counselling tool: I will not recommend vitamin D to replete older adults for heart or metabolic prevention, and I will redirect that energy toward proven measures. I would still treat documented deficiency on its own merits.
References
Duarte Romero BL, Armstrong BK, Baxter C, et al. Effect of vitamin D supplementation on cardiometabolic outcomes in older Australian adults: results from the randomized controlled D-Health trial. Nutrients. 2026;18(2):357. doi:10.3390/nu18020357