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Review

Vitamin D and Cardiovascular Disease: An Updated Narrative Review

by
Armin Zittermann
1,
Christian Trummer
2,
Verena Theiler-Schwetz
2,
Elisabeth Lerchbaum
2,
Winfried März
3,4,5 and
Stefan Pilz
2,*
1
Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia (NRW), Ruhr University Bochum, 32545 Bad Oeynhausen, Germany
2
Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, 8036 Graz, Austria
3
Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, 8036 Graz, Austria
4
SYNLAB Holding, Deutschland GmbH, 68159 Mannheim and Augsburg, Germany
5
Vth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology, Lipidology), Medical Faculty Mannheim, University of Heidelberg, 68167 Mannheim, Germany
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2021, 22(6), 2896; https://doi.org/10.3390/ijms22062896
Submission received: 20 February 2021 / Revised: 10 March 2021 / Accepted: 10 March 2021 / Published: 12 March 2021
(This article belongs to the Special Issue Nuclear Receptors and Cardiovascular Disease)
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Abstract

During the last two decades, the potential impact of vitamin D on the risk of cardiovascular disease (CVD) has been rigorously studied. Data regarding the effect of vitamin D on CVD risk are puzzling: observational data indicate an inverse nonlinear association between vitamin D status and CVD events, with the highest CVD risk at severe vitamin D deficiency; however, preclinical data and randomized controlled trials (RCTs) show several beneficial effects of vitamin D on the surrogate parameters of vascular and cardiac function. By contrast, Mendelian randomization studies and large RCTs in the general population and in patients with chronic kidney disease, a high-risk group for CVD events, largely report no significant beneficial effect of vitamin D treatment on CVD events. In patients with rickets and osteomalacia, cardiovascular complications are infrequently reported, except for an increased risk of heart failure. In conclusion, there is no strong evidence for beneficial vitamin D effects on CVD risk, either in the general population or in high-risk groups. Whether some subgroups such as individuals with severe vitamin D deficiency or a combination of low vitamin D status with specific gene variants and/or certain nutrition/lifestyle factors would benefit from vitamin D (metabolite) administration, remains to be studied.
Keywords: vitamin D; cardiovascular; heart; atherosclerosis; epidemiology; vitamin D receptor; mortality; chronic kidney disease; calcium vitamin D; cardiovascular; heart; atherosclerosis; epidemiology; vitamin D receptor; mortality; chronic kidney disease; calcium

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MDPI and ACS Style

Zittermann, A.; Trummer, C.; Theiler-Schwetz, V.; Lerchbaum, E.; März, W.; Pilz, S. Vitamin D and Cardiovascular Disease: An Updated Narrative Review. Int. J. Mol. Sci. 2021, 22, 2896. https://doi.org/10.3390/ijms22062896

AMA Style

Zittermann A, Trummer C, Theiler-Schwetz V, Lerchbaum E, März W, Pilz S. Vitamin D and Cardiovascular Disease: An Updated Narrative Review. International Journal of Molecular Sciences. 2021; 22(6):2896. https://doi.org/10.3390/ijms22062896

Chicago/Turabian Style

Zittermann, Armin, Christian Trummer, Verena Theiler-Schwetz, Elisabeth Lerchbaum, Winfried März, and Stefan Pilz. 2021. "Vitamin D and Cardiovascular Disease: An Updated Narrative Review" International Journal of Molecular Sciences 22, no. 6: 2896. https://doi.org/10.3390/ijms22062896

APA Style

Zittermann, A., Trummer, C., Theiler-Schwetz, V., Lerchbaum, E., März, W., & Pilz, S. (2021). Vitamin D and Cardiovascular Disease: An Updated Narrative Review. International Journal of Molecular Sciences, 22(6), 2896. https://doi.org/10.3390/ijms22062896

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