Association between vitamin D and cardioprotection in adult patients

A literature search was performed in the Pubmed and Scielo databases. The results were extracted from primary and secondary sources and will be presented in the form of a bibliographic review.

RESULTS:

Twenty-three articles were identified from the electronic search that reported on physiological mechanisms relating the vitamin D axis and the cardiovascular system through receptors. Of the ten studies that evaluated the therapeutic effect of vitamin D in cardiovascular diseases, none reported significant results.

CONCLUSION:

The articles assessed in this review did not demonstrate a cardioprotective effect of vitamin D, despite the epidemiological correlation of vitamin D deficiency with a higher prevalence of cardiovascular diseases.

KEYWORDS:
Vitamin D; Cardiovascular disease; Therapeutics; Prognosis

Study	Type of study	Total participants	Posology	Conclusion
Witte, et al¹⁶16. Elamin MB, Abu Elnour NO, Elamin KB, Fatourechi MM, Alkatib AA, Almandoz JP, et al. Vitamin D and cardiovascular outcomes: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2011;96(7):1931-42	ECR	Group A: Vitamin D3 Group B:Placebo Total: 223 patients	A: Vitamin D3 of 4000 IU daily for one year B: Calcium-free placebo	There was no improvement in the 6-minute walk distance, but vitamin D3 had beneficial effects on the structure and function of the left ventricle in patients under contemporary medical therapy
Gepner D, et al¹⁷17. Gepner D, Ramamurthy R, Krueger C, Korcarz E, Binkley N, Stein J. A prospective randomized controlled trial of the effects of vitamin D supplementation on cardiovascular disease risk. PLoS One. 2012;7(5):e36617	ECR	Group A: Vitamin D3 Group B:Placebo Total: 114 patients	A: Vitamin D3 2500 IU daily for four weeks B: Placebo	There was no improvement in endothelial function, arterial stiffness or inflammation
Bernini G, et al¹⁸18. Bernini G, Carrara D, Bacca A, Carli V, Virdis A, Rugani I, et al. Effect of acute and chronic vitamin D administration on systemic renin angiotensin system in essential hypertensives and controls. J Endocrinol Invest. 2013 Apr;36(4):216-20.	ECR	Total: 38 patients	A: Calcitriol 0.25 μg for one week B: Angiotensin II receptor antagonist and a single dose of cholecalciferol at 300,000 IU for eight weeks	Activation of vitamin D receptor does not influence the systemic activity of the renin-angiotensin system
Nsengiyumva V, et al¹⁹19. Nsengiyumva V, Fernando M, Moxon J, Krishna S, Pinchbeck J, Omer S, et al. The association of circulating 25-hydroxyvitamin D concentration with peripheral arterial disease: A meta-analysis of observational studies. Atherosclerosis. 2015; 243(2):645-51.	RS	Total: 8 articles with 529 participants	Vitamin D3 in the following posologies: 100,000 IU single dose for 8 weeks 200,000 IU single dose for 16 weeks 100,000 IU single dose for 16 weeks 2000 IU daily for 16 weeks 4000 IU daily for 12 weeks 2500 IU daily for 4 months, 5000 IU daily for 12 weeks Only one study described the use of paracalcitriol capsule in the dosage of 2 μg	More clinical trials are necessary to confirm or reject the benefit of vitamin D3 in endothelial dysfunction
Whitham, et al²³23. Witham MD, Ireland S, Houston JG, Gandy SJ, Waugh S, Macdonald M, et al. Vitamin D therapy to reduce blood pressure and left ventricular hypertrophy in resistant hypertension: randomized, controlled trial. Hypertension. 2014 Apr; 63(4):706-12.	ECR	Group A: Patients using 3 antihypertensive agents submitted to vitamin D3 therapy Group B: Placebo Total: 68 participants	A: Vitamin D3 at 100,000 IU every two months B: Placebo	No reduction in blood pressure or left ventricular mass in patients with resistant hypertension

Age ranges	General population (IU)	At Risk population (IU)
0 - 12 months	400	400 - 1.000
1 - 8 years	400	600 - 1.000
9 - 18 years	600	600 - 1.000
19 - 70 years	600	1.500 - 2.000
> 70 years	800	1.500 - 2.000
Pregnant women 14 - 18 years	600	600- 1000
Pregnant women >18 years	600	1.500 - 2.000
Infants 14 - 18 years	600	600 - 1.000
Infants > 18 years	600	1.500 - 2.000

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[1] CORRESPONDING AUTHOR: Gabriel Cavalcante Ferraz, Centro Universitário CESMAC, R. Cônego Machado, 984, Farol, Maceió, AL, Brasil – 57051-160 Tel: +55 82 99696-9604 E-mail: gabferraz2018@gmail.com