Future directions in vitamin D and cardiovascular research.
OBJECTIVE
Evidence is accumulating that vitamin D status may influence the risk of cardiovascular disease (CVD). Final confirmation for a causal relationship between vitamin D and CVD is however still lacking. The present viewpoint article outlines several future research directions to close this gap.


RESULTS
Future directions include the need of performing large randomised controlled supplementation trials with vitamin D in specific risk groups. In addition, large register sets of data on vitamin D supplementation can be used, provided that adequate statistical methods such as propensity score modelled analysis are applied. To better understand vitamin D-mediated effects on CVD risk, the routine measurement of circulating levels of the hormonal vitamin D form, 1,25-dihydroxyvitamin D, is also necessary, in addition to the determination of its precursor 25-hydroxyvitamin D. Further, genetic association studies may help in clarifying the contribution of vitamin D to the development of CVD. Finally, the interrelationship of vitamin D with physical activity should be considered when studying CVD risk.


CONCLUSIONS
Overall, it can be expected that the next 10-15 years will provide an increased clarity concerning the role of vitamin D in CVD.
Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Georgstraße 11, Bad Oeynhausen, Germany. azittermann@hdz-nrw.de
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Zittermann
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Börgermann
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Gummert
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Pilz
D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology*; D019587:Dietary Supplements; D056726:Genetic Association Studies / Q000639:trends; D006801:Humans; D009043:Motor Activity; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage; D014808:Vitamin D Deficiency / Q000150:complications / Q000235:genetics / Q000503:physiopathology*
D014807:Vitamin D