Vitamin D deficiency and myocardial diseases

Abstract

Vitamin D deficiency is common among patients with myocardial diseases because sun-induced vitamin D production in the skin and dietary intake of vitamin D is often insufficient. Knockout mice for the vitamin D receptor develop myocardial hypertrophy and dysfunction. It has also been shown that children with rickets who suffered from severe heart failure could be successfully treated with supplementation of vitamin D plus calcium. In adults, almost all patients with heart failure exhibit reduced 25-hydroxyvitamin D levels, which are used to classify the vitamin D status. In prospective studies, vitamin D deficiency was an independent risk factor for mortality, deaths due to heart failure and sudden cardiac death. Several vitamin D effects on the electrophysiology, contractility, and structure of the heart suggest that vitamin D deficiency might be a causal factor for myocardial diseases. Data from interventional trials, however, are rare and urgently needed to elucidate whether vitamin D supplementation is useful for the treatment of myocardial diseases. In our opinion, the current knowledge of the beneficial effects of vitamin D on myocardial and overall health strongly argue for vitamin D supplementation in all vitamin D-deficient patients with or at high risk for myocardial diseases.

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).…”

Vitamin D and musculoskeletal health, cardiovascular disease, autoimmunity and cancer: Recommendations for clinical practice

“…The evidence on the link between vitamin D deficiency and myocardial diseases has recently been reviewed [15]. In addition to possible direct effects due to the presence of the vitamin D receptor (VDR) and of the 1-alpha hydroxylase enzyme in cardiomyocytes and other cells of the cardiovascular system [16], vitamin D has significant effects on several cardiovascular risk factors.…”

A review of vitamin D status and CVD

“…As mentioned earlier, both the heart and the vasculature possess vitamin D receptors as well as the 1α-hydroxylase enzyme (12)(13)(14)(15) (18) . The mechanistic evidence on the effect of vitamin D status on myocardial diseases and CVD risk factors has been expertly reviewed elsewhere (6,7,(18)(19)(20)(21) .…”