cardiovascular-agents and Vitamin-D-Deficiency

Observational studies have suggested a possible protective role of vitamin D on the cardiovascular system. The available evidence does not support either cardiovascular benefits or harms of vitamin D supplementation. This chapter provides an overview and discussion of the current knowledge of vitamin D effects from a cardiovascular health perspective. It focuses on vitamin D in relation to cardiovascular disease, i.e. ischemic heart disease, and stroke; the traditional cardiovascular risk factors hypertension, abnormal blood lipids, obesity; and the emerging risk factors hyperparathyroidism, microalbuminuria, chronic obstructive pulmonary diseases, and non-alcoholic fatty liver disease. Meta-analyses of observational studies have largely found vitamin D levels to be inversely associated with cardiovascular risk and disease. However, Mendelian randomization studies and randomized, controlled trials (RCTs) have not been able to consistently replicate the observational findings. Several RCTs are ongoing, and the results from these are needed to clarify whether vitamin D deficiency is a causal and reversible factor to prevent cardiovascular disease.

Topics: Cardiovascular Agents; Cardiovascular Diseases; Dietary Supplements; Humans; Prognosis; Risk Factors; Vitamin D; Vitamin D Deficiency

Osteoporosis and cardiovascular diseases are epidemiologically associated. Calcification phenomena of atherosclerotic plaque involve cytokines and growth factors also involved in bone remodeling. Drugs given for either of these two conditions could act on these mechanisms. Can osteoporosis drugs have an influence on the occurrence of cardiovascular events? Conversely, can the treatment of hypertension alter the course of osteoporosis? It is possible that administration of high doses of calcium (1g/day) in patients who already have important dietary intake can increase the risk of myocardial infarction. Epidemiological studies show links between low serum vitamin D levels and cardiovascular disease but interventional studies show that vitamin D administration in moderately deficient subjects vitamin D does not prevent the occurrence of cardiovascular events. Cohort studies show a beneficial effect of beta-blockers and thiazides administered to hypertensive patients: they reduce by 20% risk of fracture of the proximal femur. Should we focus on these anti-hypertensive treatments for our patients with osteoporosis?

Topics: Adrenergic beta-Antagonists; Antihypertensive Agents; Bone Density Conservation Agents; Calcium; Calcium, Dietary; Cardiovascular Agents; Cardiovascular Diseases; Denosumab; Diphosphonates; Drug Interactions; Humans; Hypercalcemia; Hypertension; Myocardial Infarction; Osteoporosis; Sodium Chloride Symporter Inhibitors; Teriparatide; Vitamin D; Vitamin D Deficiency

Vitamin D has been known to medical science for almost a century. Yet, it is only in the last 15 years that we have realized that the biological effects of vitamin D extend far beyond the control of calcium metabolism. Recent observational evidence suggests strong links between low vitamin D levels and a range of cardiovascular conditions, including stroke, myocardial infarction, hypertension, and diabetes. Interventional studies are beginning to explore whether vitamin D supplementation can modify vascular health and prevent cardiovascular disease. This article reviews the physiology and function of vitamin D, examines the current observational and intervention data in cardiovascular disease, and discusses future research and current practice recommendations.

Topics: Cardiovascular Agents; Cardiovascular Diseases; Dietary Supplements; Evidence-Based Medicine; Humans; Practice Guidelines as Topic; Treatment Outcome; Vitamin D; Vitamin D Deficiency; Vitamins