Vitamin D and Cardiovascular Disease

Student thesis: Doctoral ThesisDoctor of Philosophy

Abstract

Evidence for the association between vitamin D status and cardiovascular disease (CVD) is reviewed. Cross-sectional analysis of data from the CRESSIDA and MARINA trials revealed a strong association between vitamin D status and arterial stiffness. An increase in vitamin D status measured as serum 25-OH-D concentrations after following advice to consume 1-2 portions of oily fish/wk was demonstrated (9.2 nmol/L, 95% CI 4.2, 14.2). The effects of malted milk drinks fortified with vitamin D2 or D3 at 5 and 10 μg/d vs. placebo taken for 4 wk on serum 25-OH-D metabolite concentrations were compared in 8 subjects/group in winter (minimal UVB exposure): mean increments ± SED vs. placebo were 9.4 ± 2.5 and 17.8 ± 2.4 nmol/L in 25-OH-D2 after 5 and 10 μg D2/d and 15.1 ± 4.7 and 22.9 ± 4.6 nmol/L in 25-OH-D3 after 5 and 10 μg D3/d. A total of 41 predominantly normotensive men and post-menopausal women (50-70 y) were randomly allocated to receive 10 μg/d D2 (Rx) or a placebo malted milk drink for 12 wk in winter. The specified primary outcomes of the trial were 24 h ambulatory blood pressure (BP) and flow mediated dilation (FMD) of the brachial artery. The mean increase ± SED in serum 25-OH-D2 on Rx vs. placebo was 22.8 ± 2.0 nmol/L (P<0.001). The treatment effects (mean changes on Rx vs. placebo with 95% CI) were 0.17% (-1.62, 1.28; P=0.82) for FMD and -4.3 mm Hg (-7.3, -1.2; P=0.007) and -2.8 mm Hg (-5.4, -0.2; P=0.032) for systolic and diastolic BP respectively. This BP lowering effect of vitamin D2 in the winter months and the null finding with regard to FMD need confirmation with a larger sample. A trial of several years duration is required to demonstrate whether the association of PWV with vitamin D status is causal.
Date of Award2014
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorThomas Sanders (Supervisor) & Philip Chowienczyk (Supervisor)

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