title: The role of vitamin D in cardiovascular disease: from present evidence to future perspectives.
abstract: Vitamin D and its metabolites have wide-spread physiological roles far beyond the well described effects in skeletal biology. Many physiological processes are directly or indirectly regulated by vitamin D and in consequence, vitamin D deficiency is implicated in numerous disease conditions. Summarizing previous assumptions on the optimal vitamin D levels in humans these data point towards calcidiol levels of approximately 30 ng/ml as being sufficient. The role of vitamin D deficiency in cardiovascular disease is a relatively novel field of interest. Well substantiated experimental data describe convincingly regulatory effects of vitamin D regarding various cardiovascular risk factors such as hypertension and diabetes mellitus. Activation of the vitamin D receptor suppresses e.g. the renin-angiotensin system. These experimental data are strongly supported by epidemiological and observational human data that link vitamin D deficiency to the incidence, degree and prevalence of cardiovascular risk factors and disease conditions. In contrast to the in vivo data and to the homogenous non-interventional observations, we know much less about controlled prospectively evaluated supplementation of vitamin D as a potentially therapeutic agent on cardiovascular events. High quality, large, and randomized controlled trials aiming primarily on cardiovascular end-points are absent. Speculations about the vitamin D usage in prevention or therapy of cardiovascular disease need to take potential drawbacks of vitamin D overdosing into account: Vitamin D overdosing might induce hypercalcemia, hyperphosphatemia, and increases in fibroblast growth-factor 23. The limited evidence regarding vitamin D therapy currently prevents general recommendations for vitamin D application in cardiology.
authors.affiliation: Department of Cardiology, University Hospital RWTH Aachen, D-52057 Aachen, Germany. vincent.brandenburg@post.rwth-aachen.de
authors.forename: Vincent M
authors.initials: VM
authors.lastname: Brandenburg
authors.forename: Marc G
authors.initials: MG
authors.lastname: Vervloet
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Marx
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism*; D019587:Dietary Supplements / Q000009:adverse effects; D004195:Disease Models, Animal; D062787:Drug Overdose; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors; D015398:Signal Transduction / Q000187:drug effects; D016896:Treatment Outcome; D014807:Vitamin D / Q000009:adverse effects / Q000097:blood / Q000378:metabolism*; D014808:Vitamin D Deficiency / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism*; D014815:Vitamins / Q000009:adverse effects
chemical_list: D014815:Vitamins; D014807:Vitamin D