Vitamin D and cardiovascular diseases: Causality

J Steroid Biochem Mol Biol. 2018 Jan:175:29-43. doi: 10.1016/j.jsbmb.2016.12.016. Epub 2016 Dec 24.


Vitamin D regulates blood pressure, cardiac functions, and endothelial and smooth muscle cell functions, thus, playing an important role in cardiovascular health. Observational studies report associations between vitamin D deficiency with hypertension and cardiovascular-related deaths. Peer-reviewed papers were examined in several research databases as per the guidelines of the Preferred Reporting Items for Systematic Reviews, using key words that address the relationship between vitamin D and cardiovascular disease. Correlations and interpretations were made considering the risks-benefits, broader evidence, and implications. This review analyzed current knowledge regarding the effects of vitamin D on the cardiovascular system. 1,25(OH)2D and related epigenetic modifications subdue cellular inflammation, improve overall endothelial functions, reduce age-related systolic hypertension and vascular rigidity, and attenuate the actions of the renin-angiotensin-aldosterone system. Most observational and ecological studies support 25(OH)vitamin D having protective effects on the cardiovascular system. However, the association of vitamin D deficiency with cardiovascular diseases is based primarily on observational and ecological studies and thus, is a matter of controversy. Adequately powered, randomized controlled clinical trial data are not available to confirm these associations. Thus, to test the hypothesis that correction of vitamin D deficiency protects the cardiovascular system, well-designed, statistically powered, longer-term clinical trials are needed in persons with vitamin D deficiency. Nevertheless, the available data support that adequate vitamin D supplementation and/or sensible sunlight exposure to achieve optimal vitamin D status are important in the prevention of cardiovascular disease and other chronic diseases.

Keywords: 25(OH)D; Cardiac; Community; Hypertension; Morbidity and mortality; Renin and angiotensin.

Publication types

  • Review

MeSH terms

  • Calcium / metabolism
  • Cardiovascular Diseases / complications
  • Cardiovascular Diseases / diet therapy
  • Cardiovascular Diseases / metabolism*
  • Cardiovascular Diseases / mortality
  • Clinical Trials as Topic
  • Dietary Supplements*
  • Humans
  • Renin-Angiotensin System / drug effects
  • Risk Factors
  • Survival Analysis
  • Ultraviolet Rays
  • Vascular Calcification / complications
  • Vascular Calcification / diet therapy
  • Vascular Calcification / genetics
  • Vascular Calcification / metabolism*
  • Vitamin D / administration & dosage*
  • Vitamin D / adverse effects
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D / metabolism
  • Vitamin D Deficiency / complications
  • Vitamin D Deficiency / diet therapy
  • Vitamin D Deficiency / metabolism*
  • Vitamin D Deficiency / mortality


  • Vitamin D
  • 1,25-dihydroxyvitamin D
  • 25-hydroxyvitamin D
  • Calcium