Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 83 000 Individuals in 21 Randomized Clinical Trials

Barbarawi, Mahmoud; Kheiri, Babikir; Zayed, Yazan; Barbarawi, Owais; Dhillon, Harsukh; Swaid, Bakr; Yelangi, Anitha; Sundus, Saira; Bachuwa, Ghassan; Alkotob, Mohammad Luay; Manson, JoAnn E.

doi:10.1001/jamacardio.2019.1870

Cited by 297 publications

(210 citation statements)

References 46 publications

(149 reference statements)

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“…In general, the results in this field are conflicting. A comprehensive 2019 meta-analysis by Barbarawi et al [95] including 83,000 participants did not find beneficial cardiovascular outcomes following vitamin D supplementation. However, further studies are needed to clarify if special subgroups could benefit from this intervention.…”

Section: Discussionmentioning

confidence: 95%

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease

et al. 2019

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Vitamin D plays a pivotal role in bone homeostasis and calcium metabolism. However, recent research has indicated additional beneficial effects of vitamin D on the cardiovascular system. This review aims to elucidate if vitamin D can be used as an add-on treatment in coronary artery disease (CAD). Large-scale epidemiological studies have found a significant inverse association between serum 25(OH)-vitamin D levels and the prevalence of essential hypertension. Likewise, epidemiological data have suggested plasma levels of vitamin D to be inversely correlated to cardiac injury after acute myocardial infarction (MI). Remarkably, in vitro trials have showed that vitamin D can actively suppress the intracellular NF-κB pathway to decrease CAD progression. This is suggested as a mechanistic link to explain how vitamin D may decrease vascular inflammation and atherosclerosis. A review of randomized controlled trials with vitamin D supplementation showed ambiguous results. This may partly be explained by heterogeneous study groups. It is suggested that subgroups of diabetic patients may benefit more from vitamin D supplementation. Moreover, some studies have indicated that calcitriol rather than cholecalciferol exerts more potent beneficial effects on atherosclerosis and CAD. Therefore, further studies are required to clarify these assumptions.

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Section: Discussionmentioning

confidence: 95%

Potential Beneficial Effects of Vitamin D in Coronary Artery Disease

et al. 2019

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“…Indeed, a study to assess the long-term effect of supplementation of vitamin D in ischemic stroke patients with low vitamin D levels found a significant improvement in the outcome after three months [168]. Nevertheless, the value of vitamin D supplementation in preventing stroke is still unclear, as a recent meta-analysis of randomized clinical trials conducted in more than 80,000 patients found no clinical benefit of vitamin D supplementation in reducing the incidence of (as opposed to outcome from) major cardiovascular events, including stroke and cardiovascular death [169]. Therefore, it is possible that vitamin D supplementation is less effective for preventing cardiovascular events than for limiting post-stroke injury and improving outcome.…”

Section: Vitamin D Deficiency and Strokementioning

confidence: 99%

Vitamin D Deficiency and the Risk of Cerebrovascular Disease

Kim

Perrelli

Ragni³

et al. 2020

Antioxidants

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Vitamin D deficiency has been clearly linked to major chronic diseases associated with oxidative stress, inflammation, and aging, including cardiovascular and neurodegenerative diseases, diabetes, and cancer. In particular, the cardiovascular system appears to be highly sensitive to vitamin D deficiency, as this may result in endothelial dysfunction and vascular defects via multiple mechanisms. Accordingly, recent research developments have led to the proposal that pharmacological interventions targeting either vitamin D deficiency or its key downstream effects, including defective autophagy and abnormal pro-oxidant and pro-inflammatory responses, may be able to limit the onset and severity of major cerebrovascular diseases, such as stroke and cerebrovascular malformations. Here we review the available evidence supporting the role of vitamin D in preventing or limiting the development of these cerebrovascular diseases, which are leading causes of disability and death all over the world.

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“…Whereas the cardiovascular safety of vitamin D supplementation is well established (7), the safety of calcium supplementation has been challenged over the last decades following publication of observational studies reporting increased incidence of various cardiovascular (CVD) endpoints including coronary artery disease (CAD) or coronary heart disease (CHD; which develops when the coronary arteries become too narrow), among users. This safety issue continues to be a scientific controversy, with several meta-analyses of studies with diverging outcomes having been published (8,9).…”

Section: Editorialmentioning

confidence: 99%