Bhaskar Medical College, Hyderabad, India.
College of Medicine and Sagore Dutta Hospital, Kolkata, India.
Curr Hypertens Rep. 2023 Aug;25(8):185-209. doi: 10.1007/s11906-023-01246-4. Epub 2023 May 31.
In this review, we discuss the evidence that vitamin D affects cardiovascular disease through interventional and observational studies and their corresponding association mechanisms. We also highlight the need for further research to definitively conclude clinical recommendations based on preliminary data and determine the extent to which vitamin D levels may impact the incidence and prognosis of major cardiovascular diseases in the future.
Cardiovascular disease has long been recognized as the leading cause of morbidity and mortality worldwide, with many risk factors implicated in its pathogenesis. Vitamin D is a risk factor that, despite being known to be crucial for its role in maintaining bone health, also has several extra-skeletal effects due to vitamin D receptors in vascular smooth muscle and cardiomyocytes. Recent studies have documented a significant association between higher vitamin D levels and lower risk of each cardiovascular disease entity; 11 studies between serum vitamin D and heart failure, 7 studies between serum vitamin D and hypertension, 8 studies between serum vitamin D and coronary artery disease, and 5 studies between serum vitamin D and atrial fibrillation. More studies documenting a significant association between increased serum vitamin D and cardiovascular disease are in the context of heart failure compared to hypertension, coronary artery disease, and atrial fibrillation. Conversely, a significant association between increased serum vitamin D and a lower risk of atrial fibrillation is reported in fewer studies compared to the association of vitamin D with other cardiovascular disease entities. Although there is evidence documenting a clear significant association of vitamin D under each category, further research is still needed to definitively conclude the role of vitamin D in cardiovascular disease management.
在本篇综述中，我们讨论了维生素 D 通过干预和观察性研究影响心血管疾病的证据，以及它们相应的关联机制。我们还强调需要进一步的研究，以便根据初步数据得出明确的临床建议，并确定维生素 D 水平在多大程度上可能影响未来主要心血管疾病的发病率和预后。
心血管疾病长期以来一直被认为是全球发病率和死亡率的主要原因，其发病机制涉及许多危险因素。维生素 D 是一个风险因素，尽管众所周知，它对维持骨骼健康至关重要，但由于维生素 D 受体在血管平滑肌和心肌细胞中的存在，它也具有多种骨骼外作用。最近的研究记录了较高的维生素 D 水平与每种心血管疾病实体风险降低之间存在显著关联；11 项血清维生素 D 与心力衰竭之间的研究、7 项血清维生素 D 与高血压之间的研究、8 项血清维生素 D 与冠状动脉疾病之间的研究以及 5 项血清维生素 D 与心房颤动之间的研究。与高血压、冠状动脉疾病和心房颤动相比，更多的研究记录了心力衰竭中血清维生素 D 增加与心血管疾病之间存在显著关联。相反，与维生素 D 与其他心血管疾病实体的关联相比，报告称血清维生素 D 增加与心房颤动风险降低之间存在显著关联的研究较少。尽管有证据表明维生素 D 在每种类别下都有明确的显著关联，但仍需要进一步的研究来明确维生素 D 在心血管疾病管理中的作用。
