Systematic Review and Meta-analysis on the Involvement of Vitamin D in Left Ventricular Remodeling among Hypertensive Individuals

A bstract Background: Vitamin D has been suggested to provide benefits for maintaining left ventricular (LV) geometry, which is critical among individuals with hypertension. Objectives: To assess the association between serum vitamin D and left ventricular geometry, and the impact of supplementation on cardiac remodeling in hypertension. Materials and Methods: A systematic search was conducted across five databases up to June 7, 2024, by adhering to the PRISMA guideline. Eligible studies included observational or interventional designs reporting LV structural parameters in relation to vitamin D status or supplementation. Standardized mean differences (SMD) or mean differences (MD) were pooled using a restricted maximum-likelihood model. Heterogeneity was estimated based on I 2 -statistics. Results: Five studies met the inclusion criteria, consisting of three observational studies ( n = 349 participants) and two clinical trials ( n = 181 participants). Observational studies showed a significant association between low serum vitamin D levels and increased LV mass index (LVMI), LV end-diastolic diameter, interventricular septum thickness, and posterior wall thickness, all with P < 0.001. A significant inverse correlation was found between serum vitamin D and LVMI ( r = −0.31, P < 0.001). Lower vitamin D levels were linked to reduced LV ejection fraction (LVEF) (SMD = −0.38, P = 0.038). However, clinical trials showed no significant effect of vitamin D supplementation on LVMI (SMD = 0.03, P = 0.753). Conclusion: Vitamin D deficiency is significantly associated with adverse changes in left ventricular geometry and reduced cardiac function. However, current evidence from clinical trials suggests that vitamin D supplementation does not significantly improve these parameters. Protocol registration: https://osf.io/5kyfx.