Vitamin D and Cardiovascular Disease

Abstract

The hormonal derivative of vitamin D, 1,25-dihydroxyvitamin D (1,25[OH](2)D) or calcitriol, has been implicated in many physiologic processes beyond calcium and phosphorus homeostasis, and likely plays a role in several chronic disease states, in particular, cardiovascular disease. Experimental data suggest that 1,25(OH)(2)D affects cardiac muscle directly, controls parathyroid hormone secretion, regulates the renin-angiotensin-aldosterone system, and modulates the immune system. Because of these biologic effects, vitamin D deficiency has been associated with hypertension, several types of vascular diseases, and heart failure. We conducted a MEDLINE search of the English-language literature (1950-2008) to identify studies that examined these relationships; additional citations were obtained from the articles retrieved from the literature search. Treatment with vitamin D lowered blood pressure in patients with hypertension and modified the cytokine profile in patients with heart failure. Measurement of serum 25-hydroxyvitamin D concentration usually provides the best assessment of an individual's vitamin D status. Serum levels below 20 ng/ml represent vitamin D deficiency, and levels above 30 ng/ml are considered optimal. Although the observational data linking vitamin D status to cardiovascular disease appear robust, vitamin D supplementation is not recommended as routine treatment for heart disease until definitive prospective, randomized trials can be carried out to assess its effects. However, such supplementation is often appropriate for other reasons and may be beneficial to cardiovascular health in certain patients.

A systematic review and meta-analysis of elevated blood pressure and consumption of dairy foods

“…There are many beneficial components of low-fat dairy foods that may contribute to their protective effects, including minerals such as calcium, 32-34 magnesium 35 and potassium, 36 vitamin D in fortified dairy foods 37 and bioactive milk peptides. 38,39 Calcium is well understood to have a role in the protective effects of low-fat dairy foods; two independent meta-analyses of randomised controlled trials, 33,34 as well as a follow-up analysis 32 showed that calcium supplementation resulted in small, significant reductions in SBP, but had no effect on DBP.…”

Maternal vitamin D status in pregnancy and adverse pregnancy outcomes in a group at high risk for pre‐eclampsia

“…16 Animal studies have also shown a link between vitamin D deficiency and cardiovascular dysfunction including cardiac hypertrophy and hypertension. 16 Other studies of pregnant women have shown seasonal variations in rates of pregnancy-induced hypertension and pre-eclampsia, suggesting that vitamin D obtained from sunshine may possibly play a role in the development of pre-eclampsia or pregnancyinduced hypertension.…”

“…16 Animal studies have also shown a link between vitamin D deficiency and cardiovascular dysfunction including cardiac hypertrophy and hypertension. 16 Other studies of pregnant women have shown seasonal variations in rates of pregnancy-induced hypertension and pre-eclampsia, suggesting that vitamin D obtained from sunshine may possibly play a role in the development of pre-eclampsia or pregnancyinduced hypertension. 17,18 However, a recent study from New South Wales, Australia showed seasonal fluctuations in pre-eclampsia and pregnancy hypertension, and suggested that increased sunlight (a proxy for vitamin D) around the time of conception was associated with increased rates of pregnancy hypertension and pre-eclampsia.…”

Vitamin D deficiency in postmenopausal, healthy women predicts increased cardiovascular events: a 16-year follow-up study

“…Increased PTH for longer periods of time may indeed have harmful effects on the cardiovascular system (7,45,46,47,48,49). The possible effects of vitamin D on the cardiovascular system have been discussed thoroughly in several overviews (50,51,52,53).…”