Effect of vitamin D supplementation on measures of arterial stiffness: a systematic review and meta‐analysis of randomized controlled trials

Abstract

SummaryBackground Low vitamin D has been associated with poor arterial compliance in observational studies. Arterial stiffness has prognostic value for cardiovascular disease risk. The aim of this systematic review was to clarify the literature surrounding the use of vitamin D to ameliorate arterial stiffness. Methods We conducted a systematic review of the MEDLINE, Scopus and EMBASE databases for randomized controlled clinical trials investigating the effect of vitamin D supplementation on pulse wave velocity (PWV) and/or augmentation index (AI) as indicators of arterial stiffness. We meta-analysed data and calculated standardized mean difference (SMD) and 95% confidence intervals (CI) using inverse-variance models on RevMan v5.3 software. Study quality was assessed using a modified Jadad scale. Results A total of 607 unique records were identified, of which 18 satisfied our inclusion and exclusion criteria. Study quality was high, ranging from 9 to 12 (of 13). Study design in terms of vitamin D dosing protocol (range: 1000-5700 IU/day), follow-up times (range: 1-12 months), sample size (range: n = 29-183) and recruitment strategies varied markedly. Thirteen studies had data for meta-analysis. Vitamin D was associated with nonsignificant reductions in PWV [SMD = À0Á10; 95% CI: À0Á24, 0Á04; P = 0Á17; n = 806 from ten studies] and AI [À0Á15; À0Á32, 0Á02; 0Á08; n = 551 from eight studies]. Discussion There is inconsistent evidence to suggest that vitamin D supplementation improves indicators of arterial stiffness. This may be attributable to the heterogeneity in study design. Therefore, large and well-designed randomized studies are

Effectiveness of Vitamin D Supplementation for Cardiovascular Health Outcomes

“…At the same time, recent systematic reviews and meta-analyses concluded that VitD has no effect on markers of arterial stiffness (included RCTs: n = 7 [113]; n = 13 [114]) or markers of endothelial function (included RCTs: n = 16 [112]). In alignment with this narrative review, almost all of the published systematic reviews highlight the significant methodological heterogeneity in terms of dose and duration of treatment, which limits the interpretation of the findings and raises the need for a critical appraisal, over and beyond the reported results.…”

“…Although some systematic reviews have used criteria to establish the quality of study design (i.e., allocation concealment, blinding, baseline comparability of groups, description of dropouts and intention-to-treat analysis), none of them have pooled the data according to the guidelines by Heaney [99]. Nevertheless, sensitivity analyses among the above analyses looking separately at either the effect of dose or duration of supplementation or baseline VitD status did not alter the null-effect findings [80,112,114]. …”

Non-classical effects of vitamin D

“…Мета-анализы указывают на отсутствие влияния приема витамина D на артериальное давление [50], ар-териальную жесткость [51,52] и эндотелиальную функ-цию [53]. На потенциальную пользу в отношении сердеч-но-сосудистой системы от приема высоких доз витамина D указывают данные ряда исследований; так, данные Zaleski и соавт.…”

Cardiovascular Effects of Long-Term Vitamin D Supplementation: Summarised by Many but Studied by Few

“…This year alone, quantitative meta-analyses of arterial stiffness outcomes have been published by Upala et al [6] and Rodríguez et al [7] summarising 7 and 18 RCTs, respectively. A recent quantitative meta-analysis on peripheral blood pressure outcomes identified 46 independent vitamin D supplementation trials [5].…”

“…These quantitative studies, although not included in the review by Veloudi et al [4], support the same conclusion which Veloudi et al [4] make from a qualitative review of RCTs, namely that vitamin D supplementation has no effect on arterial stiffness or blood pressure. However, Rodríguez et al [7] surmise that larger, well-designed RCTs are required to make sound conclusions on the effect of vitamin D supplementation on arterial stiffness. In terms of endothelial function, a quantitative meta-analysis published this year identified 16 RCTs [8], the summary of which also showed no effect of vitamin D supplementation.…”