(Circulation. 2007;115:827-828.)
© 2007 American Heart Association, Inc.
Editorial |
From the Ciccarone Preventive Cardiology Center, Johns Hopkins University School of Medicine, Baltimore, Md.
Correspondence to Roger S. Blumenthal, MD, FACC, Director, Ciccarone Preventive Cardiology Center, Blalock 524 C, Division of Cardiology, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287. E-mail rblument@jhmi.edu
Key Words: Editorials calcium cardiovascular diseases prevention risk factors vitamin D
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Many studies,1,2 but not all, have shown that low bone density is associated with increased cardiovascular disease (CVD) risk. Vitamin D deficiency is common in the elderly and is associated with osteoporosis; however, the association of endogenous 25-OH vitamin D (25-OH D) levels with CVD events is controversial.3,4 CVD rates are higher during winter seasons and at increased geographic latitudes where average serum vitamin D levels are lowest.5 Low 25-OH D levels have been found in stroke6 and heart failure patients.7 Moreover, 25-OH D deficiency is associated with hypertension, obesity,8 glucose intolerance,8 and the metabolic syndrome,9 which may be responsible, at least in part, for its association with increased CVD risk.
Article p 846
Although vitamin D supplementation improves bone strength, elevated serum vitamin D levels may be associated with lower levels of vascular calcification. In subjects at moderately high risk for coronary heart disease, endogenous serum vitamin D levels were inversely correlated with the extent of coronary artery calcification as determined by cardiac computed tomography.10 Vitamin D also has intriguing antiinflammatory properties11 that have potential therapeutic benefit in several autoimmune diseases and allograft rejection. In 2 small clinical trials,12,13 vitamin D supplementation lowered C-reactive protein levels. Additionally, 1,25(OH)2D induces relaxation of vascular smooth muscle cells and downregulation of renin production by the kidneys. Finally, the observation of reduced mortality risk with 1,25(OH)2 D supplements among patients with renal failure14 supports a possible CVD protective role of vitamin D. Accordingly, it is reasonable to hypothesize that vitamin D supplementation
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