1932

Abstract

Vitamin D is best known for its influence on skeletal health. There is growing recognition, however, that vitamin D has nonskeletal actions, which could have important implications for understanding the consequences of vitamin D deficiency. In epidemiologic studies, vitamin D deficiency has been consistently associated with an increased risk for cardiovascular disease and hypertension. Disruption of vitamin D signaling in animal models promotes hypertension, cardiac hypertrophy, and atherosclerosis. This evidence has led to the initiation of prospective randomized trials of vitamin D supplementation in individuals at risk for cardiovascular disease. The results of these trials should help to guide strategies for screening and management of vitamin D deficiency in the clinic and at the population level.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-med-051214-025146
2016-01-14
2024-04-23
Loading full text...

Full text loading...

/deliver/fulltext/med/67/1/annurev-med-051214-025146.html?itemId=/content/journals/10.1146/annurev-med-051214-025146&mimeType=html&fmt=ahah

Literature Cited

  1. Deluca HF. 1.  2014. History of the discovery of vitamin D and its active metabolites. BoneKEy Rep. 3:479 [Google Scholar]
  2. Ginde AA, Liu MC, Camargo CA Jr. 2.  2009. Demographic differences and trends of vitamin D insufficiency in the US population, 1988–2004. Arch. Intern. Med. 169:626–32 [Google Scholar]
  3. Looker AC, Dawson-Hughes B, Calvo MS. 3.  et al. 2002. Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 30:771–77 [Google Scholar]
  4. Lips P, Duong T, Oleksik A. 4.  et al. 2001. A global study of vitamin D status and parathyroid function in postmenopausal women with osteoporosis: baseline data from the multiple outcomes of raloxifene evaluation clinical trial. J. Clin. Endocrinol. Metab. 86:1212–21 [Google Scholar]
  5. Bouillon R, Carmeliet G, Verlinden L. 5.  et al. 2008. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr. Rev. 29:726–76 [Google Scholar]
  6. Cheng JB, Levine MA, Bell NH. 6.  et al. 2004. Genetic evidence that the human CYP2R1 enzyme is a key vitamin D 25-hydroxylase. PNAS 101:7711–15 [Google Scholar]
  7. Wang TJ, Zhang F, Richards JB. 7.  et al. 2010. Common genetic determinants of vitamin D insufficiency: a genome-wide association study. Lancet 376:180–88 [Google Scholar]
  8. Rosen CJ, Abrams SA, Aloia JF. 8.  et al. 2012. IOM committee members respond to endocrine society vitamin D guideline. J. Clin. Endocrinol. Metab. 97:1146–52 [Google Scholar]
  9. Holick MF, Binkley NC, Bischoff-Ferrari HA. 9.  et al. 2011. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 96:1911–30 [Google Scholar]
  10. Powe CE, Evans MK, Wenger J. 10.  et al. 2013. Vitamin D-binding protein and vitamin D status of black Americans and white Americans. N. Engl. J. Med. 369:1991–2000 [Google Scholar]
  11. Li YC, Kong J, Wei M. 11.  et al. 2002. 1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J. Clin. Investig. 110:229–38 [Google Scholar]
  12. Li YC, Qiao G, Uskokovic M. 12.  et al. 2004. Vitamin D: a negative endocrine regulator of the renin-angiotensin system and blood pressure. J. Steroid Biochem. Mol. Biol. 89–90:387–92 [Google Scholar]
  13. Tishkoff DX, Nibbelink KA, Holmberg KH. 13.  et al. 2008. Functional vitamin D receptor (VDR) in the t-tubules of cardiac myocytes: VDR knockout cardiomyocyte contractility. Endocrinology 149:558–64 [Google Scholar]
  14. Simpson RU, Hershey SH, Nibbelink KA. 14.  2007. Characterization of heart size and blood pressure in the vitamin D receptor knockout mouse. J. Steroid Biochem. Mol. Biol. 103:521–24 [Google Scholar]
  15. Zhou C, Lu F, Cao K. 15.  et al. 2008. Calcium-independent and 1,25(OH)2D3-dependent regulation of the renin-angiotensin system in 1alpha-hydroxylase knockout mice. Kidney Int. 74:170–79 [Google Scholar]
  16. Weishaar RE, Simpson RU. 16.  1987. Vitamin D3 and cardiovascular function in rats. J. Clin. Investig. 79:1706–12 [Google Scholar]
  17. Weishaar RE, Kim SN, Saunders DE, Simpson RU. 17.  1990. Involvement of vitamin D3 with cardiovascular function. III. Effects on physical and morphological properties. Am. J. Physiol. 258:E134–E42 [Google Scholar]
  18. Nibbelink KA, Tishkoff DX, Hershey SD. 18.  et al. 2007. 1,25(OH)2-vitamin D3 actions on cell proliferation, size, gene expression, and receptor localization, in the HL-1 cardiac myocyte. J. Steroid Biochem. Mol. Biol. 103:533–37 [Google Scholar]
  19. Simpson RU, Thomas GA, Arnold AJ. 19.  1985. Identification of 1,25-dihydroxyvitamin D3 receptors and activities in muscle. J. Biol. Chem. 260:8882–91 [Google Scholar]
  20. Walters MR, Wicker DC, Riggle PC. 20.  1986. 1,25-Dihydroxyvitamin D3 receptors identified in the rat heart. J. Mol. Cell Cardiol. 18:67–72 [Google Scholar]
  21. O'Connell TD, Simpson RU. 21.  1996. Immunochemical identification of the 1,25-dihydroxyvitamin D3 receptor protein in human heart. Cell Biol. Int. 20:621–24 [Google Scholar]
  22. Fraga C, Blanco M, Vigo E. 22.  et al. 2002. Ontogenesis of the vitamin D receptor in rat heart. Histochem. Cell Biol. 117:547–50 [Google Scholar]
  23. Chen S, Glenn DJ, Ni W. 23.  et al. 2008. Expression of the vitamin D receptor is increased in the hypertrophic heart. Hypertension 52:1106–12 [Google Scholar]
  24. Wu J, Garami M, Cheng T, Gardner DG. 24.  1996. 1,25(OH)2 vitamin D3, and retinoic acid antagonize endothelin-stimulated hypertrophy of neonatal rat cardiac myocytes. J. Clin. Investig. 97:1577–88 [Google Scholar]
  25. O'Connell TD, Berry JE, Jarvis AK. 25.  et al. 1997. 1,25-Dihydroxyvitamin D3 regulation of cardiac myocyte proliferation and hypertrophy. Am. J. Physiol. 272:H1751–H1758 [Google Scholar]
  26. Chen S, Law CS, Grigsby CL. 26.  et al. 2011. Cardiomyocyte-specific deletion of the vitamin D receptor gene results in cardiac hypertrophy. Circulation 124:1838–47 [Google Scholar]
  27. Bodyak N, Ayus JC, Achinger S. 27.  et al. 2007. Activated vitamin D attenuates left ventricular abnormalities induced by dietary sodium in Dahl salt-sensitive animals. PNAS 104:16810–15 [Google Scholar]
  28. Walters MR, Ilenchuk TT, Claycomb WC. 28.  1987. 1,25-Dihydroxyvitamin D3 stimulates 45Ca2+ uptake by cultured adult rat ventricular cardiac muscle cells. J. Biol. Chem. 262:2536–41 [Google Scholar]
  29. Weishaar RE, Simpson RU. 29.  1987. Involvement of vitamin D3 with cardiovascular function. II. Direct and indirect effects. Am. J. Physiol. 253:E675–E683 [Google Scholar]
  30. Green JJ, Robinson DA, Wilson GE. 30.  et al. 2006. Calcitriol modulation of cardiac contractile performance via protein kinase C. J. Mol. Cell Cardiol. 41:350–59 [Google Scholar]
  31. Somjen D, Weisman Y, Kohen F. 31.  et al. 2005. 25-Hydroxyvitamin D3-1alpha-hydroxylase is expressed in human vascular smooth muscle cells and is upregulated by parathyroid hormone and estrogenic compounds. Circulation 111:1666–71 [Google Scholar]
  32. Zehnder D, Bland R, Chana RS. 32.  et al. 2002. Synthesis of 1,25-dihydroxyvitamin D(3) by human endothelial cells is regulated by inflammatory cytokines: a novel autocrine determinant of vascular cell adhesion. J. Am. Soc. Nephrol. 13:621–29 [Google Scholar]
  33. Mitsuhashi T, Morris RC Jr, Ives HE. 33.  1991. 1,25-dihydroxyvitamin D3 modulates growth of vascular smooth muscle cells. J. Clin. Investig. 87:1889–95 [Google Scholar]
  34. Wu-Wong JR, Nakane M, Ma J. 34.  et al. 2006. Effects of Vitamin D analogs on gene expression profiling in human coronary artery smooth muscle cells. Atherosclerosis 186:20–28 [Google Scholar]
  35. Cardus A, Parisi E, Gallego C. 35.  et al. 2006. 1,25-Dihydroxyvitamin D3 stimulates vascular smooth muscle cell proliferation through a VEGF-mediated pathway. Kidney Int. 69:1377–84 [Google Scholar]
  36. Mantell DJ, Owens PE, Bundred NJ. 36.  et al. 2000. 1 alpha, 25-dihydroxyvitamin D(3) inhibits angiogenesis in vitro and in vivo. Circ. Res. 87:214–20 [Google Scholar]
  37. Wakasugi M, Noguchi T, Inoue M. 37.  et al. 1991. Vitamin D3 stimulates the production of prostacyclin by vascular smooth muscle cells. Prostaglandins 42:127–36 [Google Scholar]
  38. Giulietti A, van Etten E, Overbergh L. 38.  et al. 2007. Monocytes from type 2 diabetic patients have a pro-inflammatory profile. 1,25-Dihydroxyvitamin D(3) works as anti-inflammatory. Diabetes Res. Clin. Pract. 77:47–57 [Google Scholar]
  39. Rigby WF, Denome S, Fanger MW. 39.  1987. Regulation of lymphokine production and human T lymphocyte activation by 1,25-dihydroxyvitamin D3. Specific inhibition at the level of messenger RNA. J. Clin. Investig. 79:1659–64 [Google Scholar]
  40. Oh J, Weng S, Felton SK. 40.  et al. 2009. 1,25(OH)2 vitamin D inhibits foam cell formation and suppresses macrophage cholesterol uptake in patients with type 2 diabetes mellitus. Circulation 120:687–98 [Google Scholar]
  41. Kasuga H, Hosogane N, Matsuoka K. 41.  et al. 2002. Characterization of transgenic rats constitutively expressing vitamin D-24-hydroxylase gene. Biochem. Biophys. Res. Commun. 297:1332–38 [Google Scholar]
  42. Aihara K, Azuma H, Akaike M. 42.  et al. 2004. Disruption of nuclear vitamin D receptor gene causes enhanced thrombogenicity in mice. J. Biol. Chem. 279:35798–802 [Google Scholar]
  43. Grimes DS, Hindle E, Dyer T. 43.  1996. Sunlight, cholesterol and coronary heart disease. QJM 89:579–89 [Google Scholar]
  44. Voors AW, Johnson WD. 44.  1979. Altitude and arteriosclerotic heart disease mortality in white residents of 99 of the 100 largest cities in the United States. J. Chronic Dis. 32:157–62 [Google Scholar]
  45. Rostand SG. 45.  1997. Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension 30:150–56 [Google Scholar]
  46. Fleck A. 46.  1989. Latitude and ischaemic heart disease. Lancet 1:613 [Google Scholar]
  47. Mortimer EA Jr, Monson RR, MacMahon B. 47.  1977. Reduction in mortality from coronary heart disease in men residing at high altitude. N. Engl. J. Med. 296:581–85 [Google Scholar]
  48. Enquselassie F, Dobson AJ, Alexander HM, Steele PL. 48.  1993. Seasons, temperature and coronary disease. Int. J. Epidemiol. 22:632–36 [Google Scholar]
  49. Douglas AS, Allan TM, Rawles JM. 49.  1991. Composition of seasonality of disease. Scott. Med. J. 36:76–82 [Google Scholar]
  50. Scragg R, Jackson R, Holdaway IM. 50.  et al. 1990. Myocardial infarction is inversely associated with plasma 25-hydroxyvitamin D3 levels: a community-based study. Int. J. Epidemiol. 19:559–63 [Google Scholar]
  51. Cigolini M, Iagulli MP, Miconi V. 51.  et al. 2006. Serum 25-hydroxyvitamin D3 concentrations and prevalence of cardiovascular disease among type 2 diabetic patients. Diabetes Care 29:722–24 [Google Scholar]
  52. Poole KE, Loveridge N, Barker PJ. 52.  et al. 2006. Reduced vitamin D in acute stroke. Stroke 37:243–45 [Google Scholar]
  53. Wang TJ, Pencina MJ, Booth SL. 53.  et al. 2008. Vitamin D deficiency and risk of cardiovascular disease. Circulation 117:503–11 [Google Scholar]
  54. Giovannucci E, Liu Y, Hollis BW, Rimm EB. 54.  2008. 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch. Intern. Med. 168:1174–80 [Google Scholar]
  55. Kilkkinen A, Knekt P, Aro A. 55.  et al. 2009. Vitamin D status and the risk of cardiovascular disease death. Am. J. Epidemiol. 170:1032–39 [Google Scholar]
  56. Anderson JL, May HT, Horne BD. 56.  et al. 2010. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population. Am. J. Cardiol. 106:963–68 [Google Scholar]
  57. Wang L, Song Y, Manson JE. 57.  et al. 2012. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ. Cardiovasc. Qual. Outcomes 5:819–29 [Google Scholar]
  58. Lutsey PL, Michos ED, Misialek JR. 58.  et al. 2015. Race and Vitamin D binding protein gene polymorphisms modify the association of 25-hydroxyvitamin D and incident heart failure: the ARIC (Atherosclerosis Risk in Communities) study. J. Am. Coll. Cardiol. Heart Fail. 3:347–56 [Google Scholar]
  59. Pilz S, Marz W, Wellnitz B. 59.  et al. 2008. Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography. J. Clin. Endocrinol. Metab. 93:3927–35 [Google Scholar]
  60. Theodoratou E, Tzoulaki I, Zgaga L, Ioannidis JP. 60.  2014. Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials. BMJ 348:g2035 [Google Scholar]
  61. Forman JP, Giovannucci E, Holmes MD. 61.  et al. 2007. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension 49:1063–69 [Google Scholar]
  62. 62.  Deleted in proof
  63. Burgaz A, Orsini N, Larsson SC, Wolk A. 63.  2011. Blood 25-hydroxyvitamin D concentration and hypertension: a meta-analysis. J. Hypertens. 29:636–45 [Google Scholar]
  64. Kunutsor SK, Apekey TA, Steur M. 64.  2013. Vitamin D and risk of future hypertension: meta-analysis of 283,537 participants. Eur. J. Epidemiol. 28:205–21 [Google Scholar]
  65. Vimaleswaran KS, Cavadino A, Berry DJ. 65.  et al. 2014. Association of vitamin D status with arterial blood pressure and hypertension risk: a Mendelian randomisation study. Lancet Diabetes Endocrinol. 2:719–29 [Google Scholar]
  66. Hsia J, Heiss G, Ren H. 66.  et al. 2007. Calcium/vitamin D supplementation and cardiovascular events. Circulation 115:846–54 [Google Scholar]
  67. Trivedi DP, Doll R, Khaw KT. 67.  2003. Effect of four monthly oral vitamin D3 (cholecalciferol) supplementation on fractures and mortality in men and women living in the community: randomised double blind controlled trial. BMJ 326:469 [Google Scholar]
  68. Prince RL, Austin N, Devine A. 68.  et al. 2008. Effects of ergocalciferol added to calcium on the risk of falls in elderly high-risk women. Arch. Intern. Med. 168:103–8 [Google Scholar]
  69. Brazier M, Grados F, Kamel S. 69.  et al. 2005. Clinical and laboratory safety of one year's use of a combination calcium + vitamin D tablet in ambulatory elderly women with vitamin D insufficiency: results of a multicenter, randomized, double-blind, placebo-controlled study. Clin. Ther. 27:1885–93 [Google Scholar]
  70. Michos ED, Blumenthal RS. 70.  2007. Vitamin D supplementation and cardiovascular disease risk. Circulation 115:827–28 [Google Scholar]
  71. Sugden JA, Davies JI, Witham MD. 71.  et al. 2008. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabet. Med. 25:320–25 [Google Scholar]
  72. Joris PJ, Mensink RP. 72.  2015. Effects of supplementation with the fat-soluble vitamins E and D on fasting flow-mediated vasodilation in adults: a meta-analysis of randomized controlled trials. Nutrients 7:1728–43 [Google Scholar]
  73. Witham MD, Dove FJ, Dryburgh M. 73.  et al. 2010. The effect of different doses of vitamin D(3) on markers of vascular health in patients with type 2 diabetes: a randomised controlled trial. Diabetologia 53:2112–19 [Google Scholar]
  74. Witham MD, Price RJ, Struthers AD. 74.  et al. 2013. Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial. JAMA Int. Med. 173:1672–79 [Google Scholar]
  75. Yiu YF, Yiu KH, Siu CW. 75.  et al. 2013. Randomized controlled trial of vitamin D supplement on endothelial function in patients with type 2 diabetes. Atherosclerosis 227:140–46 [Google Scholar]
  76. Manson JE, Bassuk SS, Lee IM. 76.  et al. 2012. The VITamin D and OmegA-3 TriaL (VITAL): rationale and design of a large randomized controlled trial of vitamin D and marine omega-3 fatty acid supplements for the primary prevention of cancer and cardiovascular disease. Contemp. Clin. Trials 33:159–71 [Google Scholar]
  77. Beveridge LA, Struthers AD, Khan F. 77.  et al. 2015. Effect of Vitamin D supplementation on blood pressure: a systematic review and meta-analysis incorporating individual patient data. JAMA Intl. Med. 175:745–54 [Google Scholar]
  78. Arora P, Song Y, Dusek J. 78.  et al. 2015. Vitamin D therapy in individuals with prehypertension or hypertension: the DAYLIGHT trial. Circulation 131:254–62 [Google Scholar]
/content/journals/10.1146/annurev-med-051214-025146
Loading
/content/journals/10.1146/annurev-med-051214-025146
Loading

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error