Is Vitamin D Deficiency a New Risk Factor for Cardiovascular Disease?

Abstract

The role of vitamin D in the regulation of bone metabolism has been well established. However, in recent years, many studies have demonstrated that its role extends far beyond bone health. Growing evidence has shown a strong association between vitamin D deficiency and hypertension, metabolic syndrome, diabetes mellitus and atherosclerosis. The mechanisms by which vitamin D exerts its cardiovascular protective effects are still not completely understood, but there is evidence that it participates in the regulation of renin-angiotensin system and the mechanisms of insulin sensitivity and activity of inflammatory cytokines, besides its direct cardiovascular actions. In this review, several studies linking vitamin D deficiency with cardiometabolic risk as well as small randomized trials that have evaluated the cardiovascular effects of its supplementation are presented. However, large randomized placebo-controlled studies are still needed before we can definitively establish the role of vitamin D supplementation in the prevention and control of cardiovascular disease.

Role of Vitamin D in Various Illnesses: A Review

“…A post mortem examination of a child, who died due to vitamin D deficiency associated cardiomyopathy showed a large pericardial effusion and an enlarged heart with a dilated and concentric hypertrophic left ventricle. There was a mild increase in interstitial fibrous tissue, particularly in the subendocardial regions and the cardiomyocytes were thin and elongated in keeping with dilated cardiomyopathy [14].…”

“…In a study among 102 African Americans, vitamin D deficiency was observed in 84-96% of heart failure patients, whereas only one-third of the healthy controls were vitamin D deficient [14]. Two more studies among African Americans also showed a high prevalence of vitamin D deficiency in patients with heart failure.…”

“…1,25-dihydroxy vitamin D was shown to exert antihypertrophic effects on cardiomyocytes and reduced the expression of several genes which are upregulated in myocardial hypertrophy [14]. Suppression of the cardiac Renin-Angiotensin System (RAS) and of natriuretic peptides may partially mediate these antihypertrophic effects of vitamin D. Apart from this; vitamin D exerts various effects on the growth and differentiation of cardiomyocytes.…”

“…Results from a study among 150 patients with congestive heart failure and 150 age, sex, and race-matched controls showed that lifestyle factors associated with low 25-hydroxy vitamin D levels in earlier life (childhood, adolescence, and adulthood) including residence in large towns, low physical activity, and low frequency of summer holidays were significantly more common in heart failure patients than in controls [14].…”

“…Hypovitaminosis D is involved in the pathogenesis of rheumatoid arthritis recently gained support from an 11-year prospective study of a cohort of nearly 30,000 women aged 55 years and increased mortality in 510 patients from a specialized heart center and were an independent predictor of death and the need for cardiac transplantation in 383 end-stage congestive heart failure patients [14].…”