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Vitamin D and the cardiovascular system
1Ageing and Health, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, DD1 9SY, UK.
Summary
Vitamin D may benefit cardiovascular health through various pathways. However, current intervention studies show modest effects, and large trials are needed to confirm its role in preventing cardiovascular events.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Nutritional Science
Background:
- Vitamin D, a secosteroid hormone, influences numerous biological pathways, including those relevant to cardiovascular health.
- Observational studies link low vitamin D levels (25-hydroxyvitamin D) to increased risks of stroke, myocardial infarction, diabetes, hypertension, and heart failure.
- Potential confounding factors like reverse causality and other cardiovascular risk factors complicate observational findings.
Purpose of the Study:
- To review the mechanistic, observational, and intervention data regarding vitamin D's role in cardiovascular health.
- To assess the evidence for vitamin D's effects on blood pressure, lipids, glucose metabolism, arterial stiffness, and endothelial function.
- To determine if current evidence supports vitamin D supplementation for cardiovascular disease prevention.
Main Methods:
- Review of existing literature, including observational studies (cross-sectional and longitudinal) and intervention trials.
- Analysis of data from osteoporosis trials examining cardiovascular event rates with vitamin D supplementation.
- Evaluation of vitamin D's impact on specific cardiovascular risk factors and pathways.
Main Results:
- Observational data consistently suggests an association between low vitamin D and cardiovascular disease.
- Intervention studies indicate a modest antihypertensive effect, no impact on lipids, and a small benefit for insulin resistance and glucose.
- Analysis of osteoporosis trial data did not clearly show reduced cardiovascular events, potentially confounded by calcium co-administration and secondary analysis.
Conclusions:
- Despite promising mechanistic and observational data, intervention studies have yielded less convincing results for vitamin D in cardiovascular disease prevention.
- Current evidence does not strongly support vitamin D supplementation for cardiovascular health.
- Large-scale randomized controlled trials with cardiovascular events as primary outcomes are necessary before recommending vitamin D therapy for cardiovascular disease.
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