B-vitamin deficiency in hospitalized patients with heart failure

J Am Diet Assoc. 2009 Aug;109(8):1406-10. doi: 10.1016/j.jada.2009.05.011.


The impact of heart failure and its treatment on specific nutrient requirements is unknown. Furthermore, depletion of water-soluble B vitamins that play key roles in the production of cellular energy in patients with heart failure can contribute to depletion of energy reserves observed in the failing heart. A cross-sectional study recently reported that approximately one third of hospitalized patients with heart failure had tissue levels suggestive of thiamin deficiency (vitamin B-1). Riboflavin (vitamin B-2) and pyridoxine (vitamin B-6) are similar to thiamin in that they are water-soluble, subject to renal excretion, have limited tissue storage, and are dependent on intake. Therefore, it was hypothesized that the status of these B vitamins may also be adversely affected by heart failure. As a result, the prevalence of patients at risk of vitamin B-2 (erythrocyte glutathione reductase activity coefficient > or = 1.2) and B-6 deficiency (plasma B-6 < or = 20 nmol/L) was determined in a cross-section of 100 patients hospitalized with heart failure between April 2001 and June 2002 as well as in a group of volunteers without heart failure. Twenty-seven percent of patients with heart failure had biochemical evidence of vitamin B-2 deficiency, while 38% had evidence of B-6 deficiency. These prevalence rates were significantly higher than those observed in the volunteers without heart failure (2% and 19%, respectively; P < or = 0.02). Use of common B-vitamin-containing supplements by patients with heart failure did not significantly reduce deficiency rates in comparison with those who did not use supplements (B-2 P=0.38 or B-6 P=0.18)). Finally, while 80% of patients with heart failure took diuretics, neither the dose nor the duration of furosemide use was related to the presence of either B-2 or B-6 deficiency. Given the physiologic importance of these vitamins, further investigations aimed at determining the effect of heart failure on specific nutrient requirements as well as the safety and efficacy of B-vitamin supplementation are warranted.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Cross-Sectional Studies
  • Dietary Supplements
  • Female
  • Heart Failure / blood*
  • Heart Failure / epidemiology
  • Heart Failure / etiology
  • Hospitalization
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Nutritional Requirements*
  • Nutritional Status*
  • Odds Ratio
  • Ontario / epidemiology
  • Prevalence
  • Riboflavin / administration & dosage
  • Riboflavin / blood
  • Riboflavin Deficiency / blood
  • Riboflavin Deficiency / drug therapy
  • Riboflavin Deficiency / epidemiology*
  • Risk Factors
  • Statistics, Nonparametric
  • Thiamine / administration & dosage
  • Thiamine / blood
  • Thiamine Deficiency / blood
  • Thiamine Deficiency / drug therapy
  • Thiamine Deficiency / epidemiology
  • Vitamin B 6 / administration & dosage
  • Vitamin B 6 / blood
  • Vitamin B 6 Deficiency / blood
  • Vitamin B 6 Deficiency / drug therapy
  • Vitamin B 6 Deficiency / epidemiology*


  • Vitamin B 6
  • Riboflavin
  • Thiamine