Vitamin D: The Overlooked Factor in Cardiovascular Disease Prevention

Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality worldwide, accounting for approximately 32% of all global deaths [1]. This burden has shown to account for three quarters of deaths in low and middle income countries due to lack of preventive strategies [1]. Various interventions have been implemented to reduce the global burden of CVDs; among these, vitamin D supplementation has recently gained increasing attention as a potential therapeutic approach. Emerging evidence indicates that vitamin D deficiency is linked to a higher risk of developing cardiovascular pathologies such as hypertension, arterial stiffness, endothelial dysfunction and inflammation [2]. With the growing prevalence of Vitamin D deficiency, determining whether supplementation can help reduce the risk of CVDs has become a significant area of interest. This letter highlights the current evidence, pathogenesis, and future recommendation. Vitamin D receptors are found throughout nearly all body tissues. When these receptors are activated, they influence several physiological processes, including regulation of blood pressure via the Renin-Angiotensin-Aldosterone-System (RAAS), cytokine production in lymphocytes, reduction of vascular inflammation, and the growth and proliferation of vascular smooth muscle cells and cardiomyocytes [2, 3]. These mechanisms indicate an inverse correlation between vitamin D levels and blood pressure, showing that individuals with vitamin D deficiency face twice the risk of having a myocardial infarction, stroke and other adverse cardiovascular health outcomes [3]. Despite evidence showing a direct link between vitamin D deficiency and the mortality of CVDs, some clinical trials still suggest that vitamin D supplements should not be recommended for CVD prevention, as it can result in adverse effects such as calcification of arteries [3, 4]. As there is a lack of conclusive evidence from current randomized control trials (RCTs) regarding efficacy of vitamin D supplementation in prevention and treatment of CVDs, with mixed results reported across different populations, its routine use as preventive intervention remains limited [4]. Future research should focus on large scale, long term RCTs with emphasis on baseline vitamin D levels, genetic predisposition and gender in different populations, especially those at high risk for both deficiency and CVDs. Public health policies should prioritize preventive strategies aimed at improving Vitamin D levels through safe sun exposure, dietary modification, and supplementation when necessary, especially in low and middle income countries where both Vitamin D deficiency and CVD burden are disproportionately high [5]. In conclusion, Vitamin D, being both affordable and readily available, could offer a promising low-cost approach to reducing CVD risk, especially in resource-limited settings. However despite its potential benefits, the current evidence remains inconclusive, highlighting the need for further research. The authors declare no conflicts of interest.