Vitamin D and cardiovascular disease: systematic review and meta-analysis of prospective studies.
BACKGROUND
Low serum 25-hydroxyvitamin D (25-OH-D) has recently been linked to cardiovascular diseases. This review summarizes evidence from prospective studies evaluating the prognostic value of 25-OH-D for cardiovascular disease incidence and mortality.


METHODS
A systematic literature search in EMBASE and Pubmed-Medline databases was performed until November 2009. Prospective studies published in English were selected reporting estimates for the association of 25-OH-D with primary or secondary cardiovascular event incidence or mortality in the general population or subjects with prevalent cardiovascular disease. Pooled risk estimators were derived by meta-analysis using a random effects model approach.


RESULTS
Four incidence and five independent mortality studies were included. Two incidence and three mortality studies reported a two- to five-fold risk increase for both outcomes in subjects with lower 25-OH-D, while the others did not detect a significant association. Meta-analysis supported the existence of an inverse association.


CONCLUSIONS
Data from prospective investigations suggest an inverse association between 25-OH-D and cardiovascular risk. However, given the heterogeneity and small number of longitudinal studies, more research is needed to corroborate a potential prognostic value of 25-OH-D for cardiovascular disease incidence and mortality.
Grandi
Norma C
NC
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, D-69115 Heidelberg, Germany. n.grandi@dkfz.de
Breitling
Lutz P
LP
Brenner
Hermann
H
D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D014807:Vitamin D / Q000097:blood* / Q000502:physiology / Q000627:therapeutic use; D014815:Vitamins / Q000097:blood* / Q000502:physiology / Q000627:therapeutic use
D014815:Vitamins; D014807:Vitamin D