Vitamin D and cardiovascular disease.
Cardiovascular disease (CVD) is a major cause of morbidity and mortality worldwide. Recently vitamin D deficiency has been identified as a potential risk factor for many diseases not traditionally associated with vitamin D, such as cancer and CVD. This review discusses the evidence suggesting an association between low 25-hydroxyvitamin D levels and CVD and the possible mechanisms mediating it. Vitamin D deficiency has been associated with CVD risk factors such as hypertension and diabetes mellitus, with markers of subclinical atherosclerosis such as intima-media thickness and coronary calcification as well as with cardiovascular events such as myocardial infarction and stroke as well as congestive heart failure. It could be suggested that vitamin D deficiency contributes to the development of CVD through its association with risk factors, such as diabetes and hypertension. However, direct effects of vitamin D on the cardiovascular system may also be involved. Vitamin D receptors are expressed in a variety of tissues, including cardiomyocytes, vascular smooth muscle cells and endothelial cells and vitamin D has been shown to affect inflammation and cell proliferation and differentiation. While much evidence supports a potential antiatherosclerotic effect of vitamin D, prospective, placebo-controlled randomized as well as mechanistic studies are needed to confirm this association. Since vitamin D deficiency is easy to screen for and treat, the confirmation of such an association could have important implications for both, patient care and health policy.
Gouni-Berthold
Ioanna
I
Department of Internal Medicine II, University of Cologne, D-50937 Cologne, Germany. ioanna.berthold@uni-koeln.de
Krone
Wilhelm
W
Berthold
Heiner K
HK
D050197:Atherosclerosis / Q000150:complications / Q000235:genetics; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000378:metabolism*; D002986:Clinical Trials as Topic; D015331:Cohort Studies; D048909:Diabetes Complications / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000378:metabolism; D011110:Polymorphism, Genetic; D018167:Receptors, Calcitriol / Q000235:genetics / Q000502:physiology; D012307:Risk Factors; D014807:Vitamin D / Q000378:metabolism* / Q000502:physiology / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000150:complications; D014809:Vitamin D-Binding Protein / Q000502:physiology
D018167:Receptors, Calcitriol; D014809:Vitamin D-Binding Protein; D014807:Vitamin D