Therapeutic Potential of 25-Hydroxyvitamin D in Promoting Cardiovascular Health

Abstract

Introduction: The primary focus on vitamin D therapy was to treat metabolic bone disease. Over the past decade, however, researchers have demonstrated that vitamin D may have a role in other disease processes, particularly cardiovascular diseases (CVDs).
Review: Serum 25-hydroxyvitamin D (25(OH)D) deficiency is widespread, and is extremely common in kidney transplant recipients. In community surveys, lower levels of 25(OH)D were associated with significantly higher adjusted prevalence of cardiovascular risk factors and CVD. CVD patients have lower 25(OH)D levels than controls, which are associated with more severe disease and worse prognosis. 25(OH)D levels are inversely associated with insulin resistance and future risk of hyperglycemia in non-diabetic subjects. Low levels of 25(OH)D were found to be independent predictors of death and end stage renal disease (ESRD) in chronic kidney disease (CKD) patients. Supplementation with vitamin D was found to lower parathyroid hormone and increase anti-inflammatory cytokines in congestive heart failure patient. It was found to improve flow mediated vasodilatation of the brachial artery in asymptomatic vitamin D deficient subjects and diabetic patients. Vitamin D supplementation was found to reduce proteinuria, mortality and progression to dialysis in CKD patients and to reduce cardiovascular mortality in hemodialysis patients. Vitamin D and calcium supplementation was also found to reduce cancer risk in community dwelling healthy postmenopausal women.
Conclusion: Low levels of vitamin D seem to have undesirable effects on health. Based on the results of recent research, the recommended lower value of serum 25(OH)D is likely to be elevated.

Key Words: Vitamin D; Cardiovascular disease ; Chronic kidney disease