Archief Roodbont

Correlation between Vitamin D and Cardiovascular Events

Overall, the literature points to the observation that a low 25(OH)D concentration is closely associated with CVD. As previously discussed, several mechanisms explain the protective effects of vitamin D on the cardiovascular system: involvement of the vitamin D-PTH axis, the regulation of inflammation with its link to atherosclerosis, the regulation of the RAAS system, and the effect on insulin secretion, insulin sensitivity, and metabolic syndrome. Understanding these mechanisms assists pharmacists and other health care providers in interpreting recent studies that evaluate vitamin D deficiency and adverse cardiovascular events.

A recent investigation of the general U.S. population found that 25(OH)D deficiency (lowest quartile, <17.8>[28] Data from NHANES (2001–2004) revealed that adults with lower 25(OH)D concentrations were more likely to have CVDs such as coronary heart disease, heart failure, stroke, and peripheral arterial disease.^[36] It was discussed, however, that lower vitamin D levels might have been observed in patients with heart failure and heart disease due to limited physical activity, leading to decreased sunlight exposure, suggesting that lower vitamin D was a result of CVD, and not vice versa. However, another prospective observational study, with a mean follow-up period of 5.4 years, found that subjects with low vitamin D levels without CVD at baseline had a 53% to 80% higher rate of a CVD end point (fatal or nonfatal myocardial infarction [MI], ischemia, stroke, and heart failure).^[30] Additionally, in the Health Professionals Follow-up Study, it was found that men without CVD at baseline but with vitamin D deficiency, defined as 25(OH)D <15>[37]

Although these trials are important stepping-stones to our insight into this widely debated topic in the literature, future research is necessary to reveal the relationship between vitamin D and cardiovascular health.