Page 128 - Vitamin D and Cancer

Chapter 6
Vitamin D: Cardiovascular Function
and Disease

Robert Scragg

Abstract Opinions about the effect of vitamin D on risk of cardiovascular disease
have changed substantially over the last half century. During the 1950s and 1970s,
the dominant view was that vitamin D was a cause of cardiovascular disease. During
the 1980s and 1990s, an increasing number of studies showed benefits from vitamin
D, challenging earlier opinions that vitamin D was harmful. During the first decade
of this century, the weight of scientific opinion has shifted 180° from that of 50 years
ago, and the prevailing focus of research is on identifying the potential beneficial
effects of vitamin D against cardiovascular disease. Since 2003, large epidemiological
studies of hemodialysis patients and general population samples have shown inverse
associations between vitamin D and cardiovascular disease. A growing body of labo-
ratory and clinical research has identified several possible mechanisms to explain this
association. These include adverse effects of vitamin D deficiency on immune and
inflammatory processes, endothelial function, matrix-metalloproteinases and insulin
resistance, which result in cardiac hypertrophy, thickened arteries, increased plaque
formation, and rupture and thrombosis. Large randomized trials are required to deter-
mine with certainty whether vitamin D protects against cardiovascular disease.

Keywords 25-hydroxyvitamin D • Cardiovascular disease • Hypertension • Vitamin D

Abbreviations

CI Confidence interval
CRP C-reactive protein
CV Cardiovascular
1,25(OH) D 1,25-Dihydroxyvitamin D
2
25OHD 25-Hydroxyvitamin D
IL Interleukin
MMP Matrix-metallo-protease

R. Scragg (*)
School of Population Health, University of Auckland, Private Bag 92019,
Auckland 1142, New Zealand
e-mail: r.scragg@auckland.ac.nz

D.L. Trump and C.S. Johnson (eds.), Vitamin D and Cancer, 115
DOI 10.1007/978-1-4419-7188-3_6, © Springer Science+Business Media, LLC 2011