The effect of vitamin D level on cardiac rehabilitation in patients with Coronary Artery Disease

J Back Musculoskelet Rehabil. 2022;35(6):1373-1380. doi: 10.3233/BMR-210355.


Background: 25-hydroxy vitamin D (25OHD) deficiency is associated with cardiovascular disease and poor physical performance.

Objective: To assign the effect of 25OHD level on cardiac rehabilitation (CR) in patients with coronary artery disease (CAD).

Methods: One-hundred-thirty-five patients with CAD who underwent a CR programme were enrolled in this retrospective study. Patients were divided into two-group according to 25OHD level (Group 1: < 20 ng/dl; Group 2: ⩾ 20 ng/dl). All patients received CR for 30 sessions. Each participant performed 40 minutes of aerobic exercise with a cycloergometer followed by muscle strengthening exercises. The patients were evaluated before and after CR by a pulmonary function test (PFT) and a cardiopulmonary exercise test (CPET).

Results: There were 77 (57%) patients in Group 1 and 58 patients (43%) in Group 2. Demographic characteristics between the groups were similar. Pre- and post-rehabilitation CPET parameters were lower in Group 1 (p< 0.05). Both groups had significant improvement in CPET (p< 0.05). Post-rehabilitation PFT parameters (FEV1, FVC) were higher in Group 2 (p< 0.05). There was a positive correlation between the 25OHD-level and the CPET-PFT parameters (p< 0.05).

Conclusion: 25OHD deficiency in patients with CAD reduces the response to CR. It also affects respiratory function according to the FEV1, FVC parameters. In patients scheduled for CR, 25OHD-levels should be evaluated, and any deficiency corrected.

Keywords: Cardiac rehabilitation; cardiopulmonary exercise test; respiratory function test; vitamin D deficiency.

MeSH terms

  • Cardiac Rehabilitation*
  • Coronary Artery Disease* / complications
  • Humans
  • Retrospective Studies
  • Vitamin D
  • Vitamin D Deficiency* / complications


  • Vitamin D