Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 70, Issue 1, Pages 89-100Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2017.05.031
Keywords
blood pressure; calcifediol; cholecalciferol; diabetes mellitus; renin-angiotensin system; vascular risk factors
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Vitamin D deficiency is typically caused by inadequate cutaneous synthesis secondary to decreased exposure to sunlight. Serum levels of 25-hydroxyvitamin D l < 20 ng/ml are diagnostic of vitamin D deficiency. Vitamin D has various cardiovascular pleiotropic effects by activating its nuclear receptor in cardiomyocytes and vascular endothelial cells and by regulating the renin-angiotensin-aldosterone system, adiposity, energy expenditure, and pancreatic cell activity. In humans, vitamin D deficiency is associated with the following: vascular dysfunction; arterial stiffening; left ventricular hypertrophy; and worsened metrics of diabetes, hypertension, and hyperlipidemia. It is also linked with worse cardiovascular morbidity and mortality. However, meta-analyses of vitamin D supplementation trials have failed to show clear improvements in blood pressure, insulin sensitivity, or lipid parameters, thus suggesting that the link between vitamin D deficiency and cardiovascular disease may be an epiphenomenon. Ongoing larger randomized trials will clarify whether monitoring and supplementation of vitamin D play roles in cardiovascular protection. (C) 2017 by the American College of Cardiology Foundation.
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