A variety of information presented at the American Heart Association 2009 Scientific Sessions is pointing more strongly at th role vitamin D plays in the prevention of cardiovascular disease, not to mention osteoporosis (in combination with calcium). According to a new observational study conducted by Dr. Tami L. Bair of the Intermountain Medical Center in Murray, UT, inadequate levels of vitamin D are associated with an increase in the risk of cardiovascular disease and death. Bair and colleagues followed more than 27,000 people 50 years or older with no history of cardiovascular disease for just over a year and found that those with very low levels of vitamin D were 77 percent more likely to die, 45 percent more likely to develop coronary artery disease and 78 percent more likely to have a stroke than those with normal levels. Those deficient in vitamin D were also twice as likely to develop heart failure as those with normal levels. The researchers concluded that even a moderate deficiency of vitamin D was associated with developing coronary artery disease, heart failure, stroke, and death. But said coauthor Dr. Heidi May, it is not known whether this is a cause and effect relationship because this study was observational. More research is needed to better understand the relationship between vitamin D deficiency and CVD. There are actually some large randomized trials underway looking at outcomes with vitamin D, with results to come in five to seven years, said Dr. Eric Rimm of the Harvard School of Public Health in Boston, MA. Dr. Rimm added that, because of the existing evidence, current suggestions are for people to get 1000 or 2000 IU of vitamin D a day in the interim. The to main sources are sunlight in the form of UVB rays and diet—foods like vitamin D enriched lowfat milk and supplements. Among people at highest risk of vitamin D deficiency are those with darker skin, those living at high altitudes and the elderly because there is less of the precursor for vitamin D in the blood as people age and older people tend to spend less time outside.