Vitamin D, Calcium, and Cardiovascular Disease: A"D"vantageous or "D"etrimental? An Era of Uncertainty - PubMed (original) (raw)

Review

Vitamin D, Calcium, and Cardiovascular Disease: A"D"vantageous or "D"etrimental? An Era of Uncertainty

Kathleen Chin et al. Curr Atheroscler Rep. 2017 Jan.

Abstract

While the function of vitamin D in regulating calcium homeostasis is well established, there has been growing interest in its role in the prevention of numerous chronic diseases, including cardiovascular disease (CVD). There is mounting epidemiological evidence suggesting that vitamin D deficiency is linked to increased CVD risk. However, the results of previous vitamin D supplementation trials have yielded mixed results in regards to cardiovascular health, and the results of ongoing large-scale randomized controlled trials are not yet available. Further complicating the issue, calcium supplementation, which is often prescribed concurrently with vitamin D, has been associated with increased CVD risk in some (but not all) studies. Thus, it is currently unclear whether vitamin D supplements, particularly for those that are deficient, can help prevent the development of CVD. In addition, there has not been uniform consensus regarding the threshold of 25-hydroxyvitamin D levels that constitutes "sufficiency" across organizational guidelines. This review will provide an update on the most recent evidence regarding the effects of vitamin D and calcium supplements on CVD clinical outcomes, summarize ongoing vitamin D trials, and discuss the current but remarkably disparate recommendations regarding vitamin D deficiency screening and supplementation.

Keywords: Calcium; Cardiovascular disease; Prevention; Supplementation; Vitamin D.

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Conflict of interest statement

Conflict of Interest Disclosures: The authors have nothing to disclose related to this article. Dr. Michos reports receiving an honorarium from Siemens Diagnostics (modest) for work unrelated to this topic.

Figures

Fig. 1

Fig. 1

Proposed mechanisms by which vitamin D deficiency and high calcium levels (typically from calcium supplementation and not dietary calcium sources) may increase cardiovascular disease risk. RAAS: renin-angiotensin-aldosterone system; VSMC: vascular smooth muscle cell; LV: left ventricular

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