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Vitamin D and cardiovascular disease
1Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Clarian Bariatrics (office), 6640 Intech Blvd, Suite 300, Indianapolis, IN 46278, USA. jctemmer@iupui.edu
Insights
Vitamin D deficiency affects billions globally and may increase cardiovascular disease risk. While observational studies suggest a link, randomized controlled trials show conflicting results, leaving the association uncertain.
Area of Science:
- Endocrinology and Metabolism
- Cardiovascular Medicine
- Public Health
Background:
- Vitamin D plays a crucial role in numerous physiological and pathological processes, influencing gene expression via widespread vitamin D receptors (VDRs).
- Vitamin D deficiency is a global health concern, affecting approximately 1 billion people worldwide.
- Cardiovascular disease (CVD) is the leading cause of mortality globally, and a potential link with vitamin D status has been investigated.
Purpose of the Study:
- To review the current evidence regarding the association between vitamin D status and cardiovascular disease (CVD).
- To explore the potential role of vitamin D in cardiovascular health and risk factors.
Main Methods:
- Review of epidemiologic evidence and observational studies investigating the relationship between vitamin D deficiency and CVD.
- Analysis of data from randomized controlled trials (RCTs) assessing the impact of vitamin D supplementation on cardiovascular outcomes.
- Synthesis of existing literature to evaluate the certainty of the association between vitamin D status and CVD.
Main Results:
- Epidemiologic and observational studies consistently suggest an association between vitamin D deficiency and an increased risk of CVD.
- Randomized controlled trials (RCTs) have yielded conflicting data, with many failing to demonstrate a significant relationship between vitamin D status and CVD.
- Limitations in existing RCTs may obscure a potential beneficial effect of vitamin D on cardiovascular health.
Conclusions:
- The precise relationship between vitamin D status and cardiovascular disease remains uncertain due to conflicting study results.
- Low vitamin D levels may represent an independent and modifiable risk factor for cardiovascular disease.
- Further research is warranted to clarify the role of vitamin D in cardiovascular health and to address limitations in current trial data.
Abstract:
Vitamin D participates in numerous physiologic and pathologic processes. Most tissues have vitamin D receptors (VDRs), and vitamin D is an important regulator of gene expression. Approximately 1 billion people worldwide have insufficient levels of vitamin D. Deficiency has been associated with many chronic diseases, including cardiovascular disease (CVD), which is the leading cause of death in both men and women. A relationship between vitamin D and CVD is implicated; however studies show conflicting data. Epidemiologic evidence and observational studies demonstrate an association between vitamin D deficiency and CVD; however, this is not substantiated by randomized controlled trials (RCTs). Many questions remain unanswered, but growing evidence supports a beneficial role of vitamin D on cardiovascular health. Key teaching points: • Vitamin D influences many cellular functions. • A global pandemic of vitamin D deficiency exists. • Epidemiologic data and observational studies suggest that vitamin D deficiency may increase cardiovascular risk. • RCTs show no significant relationship (however, studies have significant limitations). • The association between vitamin D status and CVD is uncertain, but low vitamin D levels may be an independent and modifiable CV risk factor.
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