Vitamin D and the cardiovascular system.
Study Goal
The researchers aimed to evaluate the potential cardiovascular benefits and effects of vitamin D, including its interaction with calcium, based on observational and intervention studies.
Results Summary
The study found mixed results regarding vitamin D's cardiovascular benefits, with modest antihypertensive effects and small positive effects on insulin resistance, but no clear reduction in cardiovascular events, potentially confounded by calcium coadministration.
Population
General population with focus on cardiovascular health, including individuals with hypertension, diabetes, and heart failure.
Effective Dosage
Not specified
Duration
Not specified
Interactions
Coadministration of calcium may confound results.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
vitamin D | neutral | biological pathways | - | - | affects multiple biological pathways | #1 |
vitamin D | neutral | cardiovascular health | - | - | has potential benefit to cardiovascular health | #2 |
low vitamin D metabolite levels | decrease | cardiovascular health | - | - | linked to | #3 |
low 25-hydroxyvitamin D levels | increase | stroke | - | - | associated with | #4 |
low 25-hydroxyvitamin D levels | increase | myocardial infarction | - | - | associated with | #5 |
low 25-hydroxyvitamin D levels | increase | diabetes mellitus | - | - | associated with | #6 |
low 25-hydroxyvitamin D levels | increase | hypertension | - | - | associated with | #7 |
low 25-hydroxyvitamin D levels | increase | heart failure | - | - | associated with | #8 |
vitamin D | increase | incident hypertension | - | - | suggests a relationship with | #9 |
vitamin D | increase | new cardiovascular events | - | - | suggests a relationship with | #10 |
vitamin D | decrease | blood pressure | - | modest | suggest a modest antihypertensive effect | #11 |
vitamin D | no change | serum lipids | - | - | no effect on | #12 |
vitamin D | decrease | insulin resistance | - | small | a small positive effect on | #13 |
vitamin D | decrease | fasting glucose | - | small | a small positive effect on | #14 |
vitamin D | neutral | arterial stiffness | - | - | equivocal actions on | #15 |
vitamin D | neutral | endothelial function | - | - | equivocal actions on | #16 |
vitamin D supplementation | no change | cardiovascular events | patients in osteoporosis trials | - | does not currently show a clear signal for reduced | #17 |
vitamin D | decrease | cardiovascular disease | - | - | suggest a protective role for | #18 |
Vitamin D, a secosteroid hormone, affects multiple biological pathways via both genomic and nongenomic signalling. Several pathways have potential benefit to cardiovascular health, including effects on parathyroid hormone, the renin-angiotensin-aldosterone system, vascular endothelial growth factor and cytokine production, as well as direct effects on endothelial cell function and myocyte calcium influx. Observational data supports a link between low vitamin D metabolite levels and cardiovascular health. Cross-sectional data shows associations between low 25-hydroxyvitamin D levels and stroke, myocardial infarction, diabetes mellitus, hypertension, and heart failure. Longitudinal data also suggests a relationship with incident hypertension and new cardiovascular events. However, these associations are potentially confounded by reverse causality and by the effects that other cardiovascular risk factors have on vitamin D metabolite levels. Intervention studies to date suggest a modest antihypertensive effect of vitamin D, no effect on serum lipids, a small positive effect on insulin resistance and fasting glucose, and equivocal actions on arterial stiffness and endothelial function. Analysis of cardiovascular event data collected from osteoporosis trials does not currently show a clear signal for reduced cardiovascular events with vitamin D supplementation, but results may be confounded by the coadministration of calcium, and by the secondary nature of the analyses. Despite mechanistic and observational data that suggest a protective role for vitamin D in cardiovascular disease, intervention studies to date are less promising. Large trials using cardiovascular events as a primary outcome are needed before vitamin D can be recommended as a therapy for cardiovascular disease.