title: Vitamin D and cardiovascular disease.
abstract: It has long been known from case series that vitamin D excess can lead to atherosclerosis and vascular calcification in humans. In the 1980s, ecological studies provided data that deficient human vitamin D status may also increase the risk of developing cardiovascular disease (CVD). The assumption of a biphasic vitamin D effect on CVD is supported by experimental studies: Numerous studies have demonstrated positive effects of the vitamin D hormone (1,25-dihydroxyviramin D) on the cardiovascular system. However, the effects and mechanisms that lead to vascular calcification by vitamin D excess could also be confirmed. Large prospective observational studies support the hypothesis of a U-shaped association between vitamin D and CVD. These studies indicate that deficient circulating 25-hydroxyvitamin D levels (<30 nmol/l) are independently-associated with increased CVD morbidity and mortality. They also suggest that those circulating 25-hydroxyvitamin D levels, which have long been considered to be safe (100-150 nmol/l), are associated with an increased CVD risk. Meanwhile, numerous randomized controlled trials have investigated the effects of vitamin D supplements or ultraviolet B radiation on biochemical cardiovascular risk markers, cardiovascular physiology, and cardiovascular outcomes. Overall, results are mixed with the majority of studies reporting neither beneficial nor adverse vitamin D effects. Several limitations in the study design, which may have prevented beneficial vitamin D effects, are discussed. In conclusion, it must be stated that the role of vitamin D in the prevention and management of CVD as well as the dose-response relationship of potentially harmful effects still remain to be established.
authors.affiliation: Clinic for Thoracic and Cardiovascular Surgery, Heart Center NRW, Ruhr University Bochum, Bad Oeynhausen, Germany azittermann@hdz-nrw.de.
authors.forename: Armin
authors.initials: A
authors.lastname: Zittermann
mesh_terms: D000818:Animals; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000378:metabolism*; D014808:Vitamin D Deficiency / Q000150:complications
chemical_list: D014807:Vitamin D; C104450:25-hydroxyvitamin D
keywords: 1,25-dihydroxyvitamin D; 25-hydroxyvitamin D; Vitamin D; cardiovascular disease; review; vascular calcification