title: Vitamin D and cardiovascular diseases: Causality.
abstract: Vitamin D regulates blood pressure, cardiac functions, and endothelial and smooth muscle cell functions, thus, playing an important role in cardiovascular health. Observational studies report associations between vitamin D deficiency with hypertension and cardiovascular-related deaths. Peer-reviewed papers were examined in several research databases as per the guidelines of the Preferred Reporting Items for Systematic Reviews, using key words that address the relationship between vitamin D and cardiovascular disease. Correlations and interpretations were made considering the risks-benefits, broader evidence, and implications. This review analyzed current knowledge regarding the effects of vitamin D on the cardiovascular system. 1,25(OH)2D and related epigenetic modifications subdue cellular inflammation, improve overall endothelial functions, reduce age-related systolic hypertension and vascular rigidity, and attenuate the actions of the renin-angiotensin-aldosterone system. Most observational and ecological studies support 25(OH)vitamin D having protective effects on the cardiovascular system. However, the association of vitamin D deficiency with cardiovascular diseases is based primarily on observational and ecological studies and thus, is a matter of controversy. Adequately powered, randomized controlled clinical trial data are not available to confirm these associations. Thus, to test the hypothesis that correction of vitamin D deficiency protects the cardiovascular system, well-designed, statistically powered, longer-term clinical trials are needed in persons with vitamin D deficiency. Nevertheless, the available data support that adequate vitamin D supplementation and/or sensible sunlight exposure to achieve optimal vitamin D status are important in the prevention of cardiovascular disease and other chronic diseases.
authors.affiliation: Professor of Medicine, Endocrinology & Nutrition, Cardio Metabolic Institute, NJ, USA. Electronic address: suniljw@hotmail.com.
authors.forename: Sunil J
authors.initials: SJ
authors.lastname: Wimalawansa
mesh_terms: D002118:Calcium / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications / Q000178:diet therapy / Q000378:metabolism* / Q000401:mortality; D002986:Clinical Trials as Topic; D019587:Dietary Supplements; D006801:Humans; D012084:Renin-Angiotensin System / Q000187:drug effects; D012307:Risk Factors; D016019:Survival Analysis; D014466:Ultraviolet Rays; D061205:Vascular Calcification / Q000150:complications / Q000178:diet therapy / Q000235:genetics / Q000378:metabolism*; D014807:Vitamin D / Q000008:administration & dosage* / Q000009:adverse effects / Q000031:analogs & derivatives / Q000097:blood / Q000378:metabolism; D014808:Vitamin D Deficiency / Q000150:complications / Q000178:diet therapy / Q000378:metabolism* / Q000401:mortality
chemical_list: D014807:Vitamin D; C097949:1,25-dihydroxyvitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium
keywords: 25(OH)D; Cardiac; Community; Hypertension; Morbidity and mortality; Renin and angiotensin