Cardiovascular Pharmacology: Open Access

Link between Vitamin D and Cardiovascular Diseases

Kharb Manju^*, Rathi Shikha and Jalwal Pawan Department of Pharmaceutical Sciences and Research, Baba Mastnath University, Asthal Bohar, Rohtak, Haryana, 124001, India
^*Correspondence: Kharb Manju, Department of Pharmaceutical Sciences and Research, Baba Mastnath University, Asthal Bohar, Rohtak, Haryana, 124001, India, Tel: +91 9416745816, Email:

Received: 02-Feb-2019 Published: 25-Feb-2019, DOI: 10.35248/2329-6607.19.8.251

Introduction about Vitamin D

Vitamin is also called calciferol. It exist in two form vitamin D2 and vitamin D3 which are called ergocalciferol and cholecalciferol. Vitamin D3 is also called “Sunshine vitamin” because this vitamin is synthesized in epidermis cell through UV radiation and it is also consumed from fish oil and supplements [1,2]. Deficiency of vitamin D is very common problem very often unrecognized and untreated, association with osteoporosis, muscles weakness, growth retardation in children, dental caries and also increase the risk of bone fracture in adults [2-6].

Sources of Vitamin D

Vitamin D is obtained from man dietry sources like fatty acid fish or through the conversion 7-dehydrocholesterol as a pre-hormone in the skin from exposure to sun rays. Vitamin D is also obtained from plant in the form of ergosterol [6-10].

• Chiook salmon 40Z cooked (amount of vitamin D (IU) 410)

• Shrimp 40 Z cooked (amount of vitamin D (IU) 160)

• Multiple vitamin most brand (amount of vitamin D (IU) 400)

• Canned salmon, 350 Z (amount of vitamin D (IU) 30)

• Dannon fusion smoothie 100z (amount of vitamin D (IU) 80 )

• Tuna light canned in water 3 oz (amount of vitamin D (IU) 200)

• Milk 1 cup (amount of vitamin D (IU) 200)

• Cod 40 z cooked (amount of vitamin D (IU) 63)

• Fortified breakfast cereals, most brand (amount of vitamin D (IU) 40)

• Margarine, fortified 1 Tbsp (amount of vitamin D (IU) 40)

Level of Vitamin D in our Body, Effects of Vitamin D and Requirement of Vitamin D in our Body

Requirement of vitamin D in our body is based on health recommended dietry allowance are 600 IU/d for individuals aged 1 to 70 years and 800 IU/d for older than 70 years under condition of minimum sun exposure. A survey is done by NHANES (National health& nutrition examination survey) which indicate that deficiency of vitamin D exists in more than half of US middle-aged & older women and more than a third of similarly aged men. In African- Americian individuals because of darkly pigmented skin there is less synthesis of vitamin D in response to sun exposure and also black have lower dietary & supplemental vitamin D intake than white [10-13].

Mechanism by which vitamin D prevent CVD

The mechanism for how vitamin D prevent CVD is not clear but several mechanism has been proposed individuals. Such as:

Receptors of vitamin D are present throughout the vascular system including endothelial cells, vascular smooth muscles & cardiomyocytes which produce 1-α-hdroxylase enzyme. This enzyme converts 25- hdroxy vitamin D to calcitriol and this is the natural ligand of vitamin D receptor.

The calcitriol so formed inhibit proliferation of vascular smooth muscles and also regulate rennin-angiotensin system to lower BP may improving glycemic control, decrease coagulation and exhibit antiinflammatory properties [13-16].

Physiology of vitamin D

After entering into the body vitamin D follow the following route:

Vitamin D into the body bound to vit.D binding protein, liver 25- hdroxyvitamin D (25-(OH) D)

Under influence of PTH, 1-α-hydroxylase (kidney)

Hormonal vitamin D, 1,25-dihdroxy vitamin D

(1.25 (OH)2D)

Only the kidney 1-α-OH-ase significantly contributes to circulating level of 1,25-(OH)2 D level, the presence of external 1-α-OH-ase allow to convert 25 (OH) D 1,25 (OH)2 D.

Than circulating vit D1, 25 (OH)2 enters into the cells where it needed, either in free form or in binding form.

Links between Vitamin D and CVD

The main aim of this article is to explain the association of vitamin D deficiency & CVD.

Deficiency of vitamin D can cause endothelial dysfunction, proliferation of smooth muscle cells, formation of foam cells, artherosclerosis.

The other function of vitamin D is glycemic control, insulin secretion & sensitivity, lipid metabolism, prevention of secondary hyperparathyroidism.

Requirements of Vitamin D in our Body

According to institute of medicine (IOM) the current vitamin D requirement is as follow

• 200 international unit (IU) per day for adults age 50 and younger.

• 400 (IU) per day for adults age 51 to 70 years.

• 600 (IU) per day for adults aged 70 ears.

The exact amount of vitamin D is not clear known, however man physician are now recommended 1000 IU to 2000 IU daily for mist adults.

The extra amount of vitamin D can increase calcium absorption, which can cause kidney stone or kidney damage.

Uses of Vitamin D

Vitamin D has also been associated with prevention and treatment of diabetes, cancer, osteoarthritis and immune system disorder.

A growing number of studies support that low level of vitamin D increased the chances of heart diseases and that addition of vitamin D supplements can decrease the risk.

Conclusion

Several trials are done to know the connection between vitamin D deficiency and CVD but there is not yet any clear conclusive evidence.

REFERENCES

1. Quyyumi AA, Patel RS (2010) Endothelial dysfunction & hypertension: causes or effect. hypertension 55: 1094.
2. Holick MF (2007) Vitamin D deficiency. N Engl J Med 357: 266-281.
3. Looker AC, Dawson HB, Calvo MS, Gunter EW, Sahyoun NR, et al. (2002) Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 30: 771-777.
4. Giovannucci E, Liu Y, Hollis BW, Rimm EB (2008) 25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med 168: 1174-1180.
5. Dobnig H, Pilz S, Scharnagl H (2008) Independent association of low serum 25-hydroxyvitamin d and 1, 25-dihydroxyvitamin D levels with all-cause and cardiovascular mortality. Arch Intern Med 168: 1340-1349.
6. Martins D, Wolf M, Pan D, Zadshir A, Tareen N, et al. (2007) Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 167: 1159-1165.
7. Khazai N, Judd SE, Tangpricha V (2008) Calcium and vitamin D: skeletal and extraskeletal health. Curr Rheumatol Rep 10: 110-117.
8. Nibbelink KA, Tishkoff DX, Hershey SD, Rahman A, Simpson RU, et al. (2007) 1,25(OH)2-vitamin D3 actions on cell proliferation, size, gene expression, and receptor localization, in the HL-1 cardiac myocyte. J Steroid Biochem Mol Biol 103: 533-7.
9. Grimes DS, Hindle E, Dyer T (1996) Sunlight, cholesterol and coronary heart disease. QJM 89: 579- 89.
10. Douglas AS, Dunnigan MG, Allan TM, J M Rawles (1995) Seasonal variation in coronary heart disease in Scotland. J Epid Comm Health 49: 575-82.
11. Rostand SG (1997) Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension 30: 150-156.
12. Melamed ML, Michos ED, Post W, Brad Astor (2008) 25-Hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med 168: 1629-1637.
13. Giovannucci E, Liu Y, Hollis BW (2008) 25-Hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med 168: 1174-1180.
14. Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, et al. (2008 ) Vitamin D deficiency and risk of cardiovascular disease. Circulation 117: 503-511.
15. Pilz S, März W, Wellnitz B, Ursula Seelhorst, Pammer AF, et al. (2008) Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography. J Clin Endocrinol Metab 93: 3927-35.
16. Rowling MJ, Kemmis CM, Taffany DA, Welsh J (2006) Megalin-mediated endocytosis of vitamin D binding protein correlates with 25-hydroxy-cholecalciferol actions in human mammary cells. J Nutr 136: 2754-2749.