Vitamin B-6 and Cardiovascular Disease

Vitamin B6 deficiency needs to be addressed more seriously among physicians.

Nutrition for Optimal Wellness | Greg Arnold, DC, CSCS | Cardiovascular diseases, including heart disease and stroke, are the first and third leading causes of death for both men and women in the U.S. and account for 1 in 3 of all U.S. deaths. Heart disease and stroke are expected to cost our healthcare system $473 billion in 2009. If all major types of cardiovascular disease were eliminated, U.S. life expectancy would increase by nearly 7 years (1).

While vitamin D (2), fiber (3), barley (4), and maintaining a healthy blood pressure (5) have been found to help maintain heart health, a new study (6) examined vitamin B6, known to help colorectal health (7) and healthy inflammatory response (8).

In the study, researchers conducted a review of the scientific literature analyzing blood levels of vitamin B6 and the subjects' risk of chronic diseases, including coronary artery disease and heart attack. When examining blood levels of vitamin B6, the researchers specifically looked at levels of the major form of vitamin B6 called PLP, which is considered the most sensitive indicator for B6 in the blood (9). The researchers classified vitamin B6 deficiency as having PLP levels below 20 nanomoles/Liter (nmo/L) and "marginal B6 status" as having PLP levels below 30 nmol/L (10).

For coronary artery disease:

• Those with PLP levels below 20 nmol/L (and therefore classified as B6 deficient) had a 139% increased risk of coronary heart disease. When the researchers included the increased levels of an inflammatory protein called hs-CRP (> 6 mg/L), the risk increased to 237% (11).

• Those with PLP levels below 30 nmol/L (and therefore classified as "marginal B6 status) had an 85% increased risk of coronary artery disease (12).

For heart attack:

• Those with PLP levels below 28.9 nmol/L had a 50% increased risk of having a heart attack (13).

• Those with the highest 33% of vitamin B6 intake (greater than 2.05 milligrams per day) had a 66% reduced risk of having a heart attack compared to those with the lowest 20% of vitamin B6 intake (less than 1.65 mg per day) (14)

For the researchers, vitamin B6 deficiency needs to be addressed more seriously among physicians as they feel it represents "…a subclinical at-risk condition in inflammatory-linked diseases..."

Reference:

1. "Cardiovascular Disease at a Glance" posted on www.cdc.gov/
2. Parker J. Levels of vitamin D and cardiometabolic disorders: Systematic review and meta-analysis. Maturitas 2010; 65(3): 225-236
3. Ma J. Association between dietary fiber and serum C-reactive protein. Am J Clin Nutr 2006;83 760-766
4. "FDA Finalizes Health Claim Associating Consumption of Barley Products with Reduction of Risk of Coronary Heart Disease" posted May 19, 2006 on the FDA Website www.fda.gov/bbs/topics/NEWS/2006/NEW01375.html
5. David Conen D. Blood pressure progression: prospective cohort study with high normal blood pressure or blood Risk of cardiovascular events among women. BMJ published online 19 Aug 2007; doi:10.1136/bmj.39269.672188.AE
6. Lotto V. Vitamin B6: a challenging link between nutrition and inflammation in CVD. British Journal of Nutrition (2011). doi:10.1017/S0007114511000407
7. Larsson SC. Vitamin B6 and Risk of Colorectal Cancer: A Meta-analysis of Prospective Studies JAMA. 2010;303(11):1077-1083
8. Shen J. Association of vitamin B-6 status with inflammation, oxidative stress, and chronic inflammatory conditions: the Boston Puerto Rican Health Study Am J Clin Nutr 2010 91: 337-342. First published online December 2, 2009; doi:10.3945/ajcn.2009.28571
9. Lui A, Lumeng L, Aronoff GR, et al. (1985) Relationship between body store of vitamin B6 and plasma pyridoxal-P clearance: metabolic balance studies in humans. J Lab Clin Med 106, 491–497.
10. Leklem JE (1990) Vitamin B-6: a status report. J Nutr 120, Suppl. 11, 1503–1507.
11. Cheng CH, Lin PT, Liaw YP, et al. (2008) Plasma pyridoxal 50-phosphate and high-sensitivity C-reactive protein are independently associated with an increased risk of coronary artery disease. Nutrition 24, 239–244
12. Lin PT, Cheng CH, Liaw YP, et al. (2006) Low pyridoxal 50-phosphate is associated with increased risk of coronary artery disease. Nutrition 22, 1146–1151.
13. Chasan-Taber L, Selhub J, Rosenberg IH, et al. (1996) A prospective study of folate and vitamin B6 and risk of myocardial infarction in US physicians. J Am Coll Nutr 15, 136–143.
14. Tavani A, Pelucchi C, Parpinel M, et al. (2004) Folate and vitamin B(6) intake and risk of acute myocardial infarction in Italy. Eur J Clin Nutr 58, 1266–1272.

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