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Vitamin D Therapy and Cardiovascular Health

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Abstract

Vitamin D belongs to the family of nuclear steroid hormones, which has pleiotropic effects on several organ systems. Different vitamin D compounds have been studied as potential cardioprotective agents over the past 20 years. The results of these clinical studies vary based on the form and dosage of vitamin D administered during the trial. In the past 5 years, many have described an association of vitamin D compounds and cardiovascular health through reduction in blood pressure, reduction in inflammatory biomarkers, improved insulin sensitivity, and reduction in cardiovascular disease complications and death. Because there are several vitamin D compounds, it is important to consider the full breadth of the literature when examining vitamin D and cardiovascular health, to assist in hypothesis generation and understanding of the current state of the science. Although a growing body of evidence suggests that nutritional vitamin D supplementation and potentially even treatment with synthetic analogues of vitamin D may be cardioprotective, relatively few studies have examined either of these compounds in a randomized, controlled fashion. Studies examining the benefit of vitamin D supplementation are now beginning, but future studies considering calcitriol and analogue therapy also seem warranted.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Feldman D, Glorieux FH, Pike JW, Chesney R. Vitamin D. Ann Arbor: Elsevier Academic; 1998.

    Google Scholar 

  2. Holick MF. Vitamin D: a millenium perspective. J Cell Biochem. 2003;88(2):296–307.

    Article  PubMed  CAS  Google Scholar 

  3. Zerwekh JE. Blood biomarkers of vitamin D status. Am J Clin Nutr. 2008;87(4):1087S–91S.

    PubMed  CAS  Google Scholar 

  4. Heaney RP, Davies KM, Chen TC, Holick MF, Barger-Lux MJ. Human serum 25-hydroxycholecalciferol response to extended oral dosing with cholecalciferol. Am J Clin Nutr. 2003;77(1):204–10.

    PubMed  CAS  Google Scholar 

  5. Gilchrest BA. Sun exposure and vitamin D sufficiency. Am J Clin Nutr. 2008;88(2):570S–7S.

    PubMed  CAS  Google Scholar 

  6. McCarty CA. Sunlight exposure assessment: can we accurately assess vitamin D exposure from sunlight questionnaires? Am J Clin Nutr. 2008;87(4):1097S–101S.

    PubMed  CAS  Google Scholar 

  7. Millen AE, Bodnar LM. Vitamin D assessment in population-based studies: a review of the issues. Am J Clin Nutr. 2008;87(4):1102S–5S.

    PubMed  CAS  Google Scholar 

  8. Haddad JG. Plasma vitamin D-binding protein (Gc-globulin): multiple tasks. J Steroid Biochem Mol Biol. 1995;53(1–6):579–82.

    Article  PubMed  CAS  Google Scholar 

  9. White P, Cooke N. The multifunctional properties and characteristics of vitamin D-binding protein. Trends Endocrinol Metab. 2000;11(8):320–7.

    Article  PubMed  CAS  Google Scholar 

  10. Nykjaer A, Dragun D, Walther D, Vorum H, Jacobsen C, Herz J, et al. An endocytic pathway essential for renal uptake and activation of the steroid 25-(OH) vitamin D3. Cell. 1999;96(4):507–15.

    Article  PubMed  CAS  Google Scholar 

  11. Prentice A, Goldberg GR, Schoenmakers I. Vitamin D across the lifecycle: physiology and biomarkers. Am J Clin Nutr. 2008;88(2):500S–6S.

    PubMed  CAS  Google Scholar 

  12. Judd SE, Tangpricha V. Vitamin D deficiency and risk for cardiovascular disease. Am J Med Sci. 2009;338(1):40–4.

    Article  PubMed  Google Scholar 

  13. Li YC, Kong J, Wei M, Chen ZF, Liu SQ, Cao LP. 1, 25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system. J Clin Invest. 2002;110(2):229–38.

    PubMed  CAS  Google Scholar 

  14. Rostand SG. Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension. 1997;30(2 Pt 1):150–6.

    PubMed  CAS  Google Scholar 

  15. Scragg R, Khaw KT, Murphy S. Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr. 1995;49(9):640–6.

    PubMed  CAS  Google Scholar 

  16. • Judd SE, Nanes MS, Ziegler TR, Wilson PW, Tangpricha V. Optimal vitamin D status attenuates the age-associated increase in systolic blood pressure in white Americans: results from the third National Health and Nutrition Examination Survey. Am J Clin Nutr. 2008;87(1):136–41. This was one of the first reports demonstrating that optimal vitamin D status decreased the age-related rise in systolic blood pressure in NHANES.

    PubMed  CAS  Google Scholar 

  17. Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens. 2007;20(7):713–9.

    Article  PubMed  CAS  Google Scholar 

  18. Forman JP, Bischoff-Ferrari HA, Willett WC, Stampfer MJ, Curhan GC. Vitamin D intake and risk of incident hypertension: results from three large prospective cohort studies. Hypertension. 2005;46(4):676–82.

    Article  PubMed  CAS  Google Scholar 

  19. Forman JP, Giovannucci E, Holmes MD, Bischoff-Ferrari HA, Tworoger SS, Willett WC, et al. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension. 2007;49(5):1063–9.

    Article  PubMed  CAS  Google Scholar 

  20. • Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117(4):503–11. This large Framingham cohort study demonstrated increased cardiovascular events in participants with vitamin D deficiency.

    Article  PubMed  CAS  Google Scholar 

  21. Sowers MR, Wallace RB, Lemke JH. The association of intakes of vitamin D and calcium with blood pressure among women. Am J Clin Nutr. 1985;42(1):135–42.

    PubMed  CAS  Google Scholar 

  22. Boucher BJ. Calcium and vitamin D intakes and blood pressure. Am J Clin Nutr. 2001;73(3):659–60.

    PubMed  CAS  Google Scholar 

  23. Townsend MS, Fulgoni 3rd VL, Stern JS, Adu-Afarwuah S, McCarron DA. Low mineral intake is associated with high systolic blood pressure in the Third and Fourth National Health and Nutrition Examination Surveys: could we all be right? [see comment]. Am J Hypertens. 2005;18(2 Pt 1):261–9.

    Article  PubMed  Google Scholar 

  24. Jorde R, Bonaa KH. Calcium from dairy products, vitamin D intake, and blood pressure: the Tromso Study. Am J Clin Nutr. 2000;71(6):1530–5.

    PubMed  CAS  Google Scholar 

  25. • Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168(11):1174–80. The Health Professionals Follow-up Study demonstrated increased risk of myocardial infarction with vitamin D deficiency.

    Article  PubMed  CAS  Google Scholar 

  26. Krause R, Buhring M, Hopfenmuller W, Holick MF, Sharma AM. Ultraviolet B and blood pressure. Lancet. 1998;352(9129):709–10.

    Article  PubMed  CAS  Google Scholar 

  27. Pfeifer M, Begerow B, Minne HW, Nachtigall D, Hansen C. Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab. 2001;86(4):1633–7.

    Article  PubMed  CAS  Google Scholar 

  28. Li YC. Vitamin D regulation of the renin-angiotensin system. J Cell Biochem. 2003;88(2):327–31.

    Article  PubMed  CAS  Google Scholar 

  29. Li YC, Qiao G, Uskokovic M, Xiang W, Zheng W, Kong J. Vitamin D: a negative endocrine regulator of the renin-angiotensin system and blood pressure. J Steroid Biochem Mol Biol. 2004;89–90(1–5):387–92.

    Article  PubMed  Google Scholar 

  30. Zhou CL, Lu FX, Cao KX, Xu D, Goltzman D, Miao DS. Calcium-independent and 1, 25 (OH) 2 D 3-dependent regulation of the renin-angiotensin system in 1 alpha-hydroxylase knockout mice. Kidney Int. 2008;74(2):170.

    Article  PubMed  CAS  Google Scholar 

  31. Burgess ED, Hawkins RG, Watanabe M. Interaction of 1, 25-dihydroxyvitamin D and plasma renin activity in high renin essential hypertension. Am J Hypertens. 1990;3(12 Pt 1):903–5.

    PubMed  CAS  Google Scholar 

  32. Kimura Y, Kawamura M, Owada M, Oshima T, Murooka M, Fujiwara T, et al. Effectiveness of 1, 25-dihydroxyvitamin D supplementation on blood pressure reduction in a pseudohypoparathyroidism patient with high renin activity. Intern Med. 1999;38(1):31–5.

    Article  PubMed  CAS  Google Scholar 

  33. Qiao G, Kong J, Uskokovic M, Li YC. Analogs of 1alpha, 25-dihydroxyvitamin D(3) as novel inhibitors of renin biosynthesis. J Steroid Biochem Mol Biol. 2005;96(1):59–66.

    Article  PubMed  CAS  Google Scholar 

  34. Sigmund CD. Regulation of renin expression and blood pressure by vitamin D(3). J Clin Invest. 2002;110(2):155–6.

    PubMed  CAS  Google Scholar 

  35. Giulietti A, van Etten E, Overbergh L, Stoffels K, Bouillon R, Mathieu C. Monocytes from type 2 diabetic patients have a pro-inflammatory profile 1, 25-Dihydroxyvitamin D3 works as anti-inflammatory. Diabetes Res Clin Pract. 2007;77(1):47–57.

    Article  PubMed  CAS  Google Scholar 

  36. Stubbs JR, Idiculla A, Slusser J, Menard R, Quarles LD. Cholecalciferol supplementation alters calcitriol-responsive monocyte proteins and decreases inflammatory cytokines in ESRD. J Am Soc Nephrol. 2010;21(2):353–61.

    Article  PubMed  CAS  Google Scholar 

  37. Doughan AK, Harrison DG, Dikalov SI. Molecular mechanisms of angiotensin II-mediated mitochondrial dysfunction: linking mitochondrial oxidative damage and vascular endothelial dysfunction. Circ Res. 2008;102(4):488–96.

    Article  PubMed  CAS  Google Scholar 

  38. Harrison DG, Cai H, Landmesser U, Griendling KK. Interactions of angiotensin II with NAD(P)H oxidase, oxidant stress and cardiovascular disease. J Renin Angiotensin Aldosterone Syst. 2003;4(2):51–61.

    Article  PubMed  CAS  Google Scholar 

  39. Harrison DG, Guzik TJ, Goronzy J, Weyand C. Is hypertension an immunologic disease? Curr Cardiol Rep. 2008;10(6):464–9.

    Article  PubMed  Google Scholar 

  40. Jespersen B, Randlov A, Abrahamsen J, Fogh-Andersen N, Olsen NV, Kanstrup IL. Acute cardiovascular effect of 1, 25-dihydroxycholecalciferol in essential hypertension. Am J Hypertens. 1998;11(6 Pt 1):659–66.

    Article  PubMed  CAS  Google Scholar 

  41. Lind L, Hanni A, Lithell H, Hvarfner A, Sorensen OH, Ljunghall S. Vitamin D is related to blood pressure and other cardiovascular risk factors in middle-aged men. Am J Hypertens. 1995;8(9):894–901.

    Article  PubMed  CAS  Google Scholar 

  42. Kristal-Boneh E, Froom P, Harari G, Ribak J. Association of calcitriol and blood pressure in normotensive men. Hypertension. 1997;30(5):1289–94.

    PubMed  CAS  Google Scholar 

  43. Bukoski RD, DeWan P, McCarron DA. 1, 25 (OH) 2 vitamin D3 modifies growth and contractile function of vascular smooth muscle of spontaneously hypertensive rats. Am J Hypertens. 1989;2(7):553–6.

    PubMed  CAS  Google Scholar 

  44. Bukoski RD, Xue H. On the vascular inotropic action of 1, 25-(OH) 2 vitamin D3. Am J Hypertens. 1993;6(5 Pt 1):388–96.

    PubMed  CAS  Google Scholar 

  45. Judd SE, Raiser SN, Kumari M, Tangpricha V. 1, 25-dihydroxyvitamin D3 reduces systolic blood pressure in hypertensive adults: a pilot feasibility study. J Steroid Biochem Mol Biol. 2010;121(1–2):445–7.

    Article  PubMed  CAS  Google Scholar 

  46. Scragg R, Holdaway I, Singh V, Metcalf P, Baker J, Dryson E. Serum 25-hydroxycholecalciferol concentration in newly detected hypertension. Am J Hypertens. 1995;8(4 Pt 1):429–32.

    Article  PubMed  CAS  Google Scholar 

  47. Brickman AS, Nyby MD, von Hungen K, Eggena P, Tuck ML. Calcitropic hormones, platelet calcium, and blood pressure in essential hypertension. Hypertension. 1990;16(5):515–22.

    PubMed  CAS  Google Scholar 

  48. Bukoski RD, Kremer D. Calcium-regulating hormones in hypertension: vascular actions. Am J Clin Nutr. 1991;54(1 Suppl):220S–6S.

    PubMed  CAS  Google Scholar 

  49. Hajjar IM, Grim CE, George V, Kotchen TA. Impact of diet on blood pressure and age-related changes in blood pressure in the US population: analysis of NHANES III. Arch Intern Med. 2001;161(4):589–93.

    Article  PubMed  CAS  Google Scholar 

  50. Sowers MF, Wallace RB, Hollis BW, Lemke JH. Relationship between 1, 25-dihydroxyvitamin D and blood pressure in a geographically defined population. Am J Clin Nutr. 1988;48(4):1053–6.

    PubMed  CAS  Google Scholar 

  51. Resnick LM, Muller FB, Laragh JH. Calcium-regulating hormones in essential hypertension. Relation to plasma renin activity and sodium metabolism. Ann Intern Med. 1986;105(5):649–54.

    PubMed  CAS  Google Scholar 

  52. Sugden JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabet Med. 2008;25(3):320–5.

    Article  PubMed  CAS  Google Scholar 

  53. Manson JE, Allison MA, Carr JJ, Langer RD, Cochrane BB, Hendrix SL, et al. Calcium/vitamin D supplementation and coronary artery calcification in the Women’s Health Initiative. Menopause. 2010;17(4):683–91.

    PubMed  Google Scholar 

  54. Margolis KL, Martin LW, Ray RM, Kerby TJ, Allison M, Curb JD, et al. Abstract 1069: does a higher serum 25(OH) vitamin D level predict lower blood pressure in post-menopausal women? Prospective data from the Women’s Health Initiative [abstract 1069]. Circulation. 2009;120(18[Meeting Abstracts]):S439.

  55. LaCroix AZ, Kotchen J, Anderson G, Brzyski R, Cauley JA, Cummings SR, et al. Calcium plus vitamin D supplementation and mortality in postmenopausal women: the Women’s Health Initiative calcium-vitamin D randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2009;64(5):559–67.

    Article  PubMed  Google Scholar 

  56. Rajpathak SN, Xue X, Wassertheil-Smoller S, Van Horn L, Robinson JG, Liu S, et al. Effect of 5 y of calcium plus vitamin D supplementation on change in circulating lipids: results from the Women’s Health Initiative. Am J Clin Nutr. 2010;91(4):894–9.

    Article  PubMed  CAS  Google Scholar 

  57. Millen AE, Wactawski-Wende J, Pettinger M, Melamed ML, Tylavsky FA, Liu S, et al. Predictors of serum 25-hydroxyvitamin D concentrations among postmenopausal women: the Women’s Health Initiative Calcium plus Vitamin D Clinical Trial. Am J Clin Nutr. 2010;91(5):1324–35.

    Article  PubMed  CAS  Google Scholar 

  58. Witham MD, Nadir MA, Struthers AD. Effect of vitamin D on blood pressure: a systematic review and meta-analysis. J Hypertens. 2009;27(10):1948–54.

    Article  PubMed  CAS  Google Scholar 

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Judd, S.E., Tangpricha, V. Vitamin D Therapy and Cardiovascular Health. Curr Hypertens Rep 13, 187–191 (2011). https://doi.org/10.1007/s11906-011-0190-2

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