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Vitamin D for the Prevention of Cardiovascular Disease: Are we ready for that - June 2015

Vitamin D for the Prevention of Cardiovascular Disease: Are we ready for that?

Atherosclerosis Available online 21 June 2015, doi:10.1016/j.atherosclerosis.2015.06.034
Luiz Sergio F. Carvalho, MD MSc PhDa, b, Professor Andrei C. Sposito, MD PhDa,
Highlights
•Vitamin D was implicated endothelium-mediated vasodilation and anti-coagulant activity.
•Vitamin D may reduce blood pressure, myocardial hypertrophy and arrhythmias.
•Association of CVD and VitD were not consistent in longitudinal studies and trials.
•Discussion on a critical bias on the methods for measuring plasma vitamin D.
•Misinterpretation of results and limiting conclusions of several studies on vitamin D.
A general concept of clinical benefit of vitamin D supplementation has emerged from the evidence in prevention of osteoporosis. From the cardiovascular point of view, clinical benefit of such supplementation remains less clear. Studies in vitro and in animal models demonstrated the expression of vitamin D receptors in endothelial cells, vascular smooth muscle and cardiomyocytes.

Vitamin D has been directly implicated in

  • endothelium-mediated vasodilation,
  • anti-coagulant activity and
  • inhibition of the inflammatory response.

Indirectly, it may favor the

  • reduction of blood pressure,
  • myocardial hypertrophy and
  • ventricular arrhythmias.

In contrast to these mechanistic findings, cross-sectional, longitudinal and small clinical trials have not been consistent in demonstrating association between cardiovascular events and vitamin D. Besides, methodological issues in the tests for serum levels of vitamin D may also contribute to this puzzle.
Hence, in the current state of knowledge, it may be too early to consider or to rule out vitamin D as a tool to either estimate or mitigate residual cardiovascular risk. In this review, we discuss recent advances and potential limitations in mechanistic and clinical evidences that are outlining the framework of interaction between vitamin D and cardiovascular risk.

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See also VitaminDWiki

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