THE ROLE OF VITAMIN D IN PATHOGENESIS AND PREVENTION OF CARDIOVASCULAR DISEASES - A LITERATURE REVIEW

Natalia Jankowska; Adrianna Świerzyńska; Tomasz Puszkiel; Aleksandra Simlat; Aleksandra Cieciora; Angelika Szwaj; Ilona Mariańska-Wiśniewska; Julia Surowiec; Małgorzata Kawiorska; Mateusz Cieciora

doi:10.31435/ijitss.1(49).2026.4633

Authors

Natalia Jankowska University of Technology and Humanities in Radom, Radom, Poland https://orcid.org/0009-0000-3618-6247
Adrianna Świerzyńska University of Technology and Humanities in Radom, Radom, Poland https://orcid.org/0009-0007-1451-3009
Tomasz Puszkiel University of Technology and Humanities in Radom, Radom, Poland https://orcid.org/0009-0006-5413-7530
Aleksandra Simlat University of Technology and Humanities in Radom, Radom, Poland https://orcid.org/0009-0000-8949-5756
Aleksandra Cieciora University of Technology and Humanities in Radom, Radom, Poland https://orcid.org/0009-0009-7999-4047
Angelika Szwaj University of Technology and Humanities in Radom, Radom, Poland https://orcid.org/0009-0007-4257-0844
Ilona Mariańska-Wiśniewska Specjalistyczny Szpital Miejski im. M. Kopernika, Toruń, Poland https://orcid.org/0009-0007-1556-2910
Julia Surowiec University of Technology and Humanities in Radom, Radom, Poland https://orcid.org/0009-0009-3356-8261
Małgorzata Kawiorska University of Technology and Humanities in Radom, Radom, Poland https://orcid.org/0009-0000-3184-7659
Mateusz Cieciora University of Technology and Humanities in Radom, Radom, Poland https://orcid.org/0009-0008-0711-9377

DOI:

https://doi.org/10.31435/ijitss.1(49).2026.4633

Keywords:

Vitamin D, Cardiovascular Diseases, Vitamin D Deficiency, Atherosclerosis, Supplementation, Cardiovascular Risk

Abstract

Introduction: Cardiovascular diseases remain the leading cause of mortality worldwide, and its incidence is increasing with the population aging. A growing number of studies indicate that vitamin D deficiency, which is common in the global population, may play an important role in the pathogenesis of cardiovascular diseases by influencing inflammatory processes, oxidative stress, the renin-angiotensin-aldosterone system, calcium-phosphate metabolism, and endothelial function. As a result, vitamin D has become the subject of intensive analysis regarding its potential impact on the prognosis of patients with hypertension, heart failure, atherosclerosis, diabetes, and arrhythmias.

Aim of the study: The aim of the study was to present the current state of knowledge on the association between vitamin D deficiency and the risk and management of cardiovascular diseases, as well as to evaluate the role of vitamin D supplementation in the prevention and treatment of these diseases.

Material and methods: This paper provides a review of the literature including current experimental, observational, and randomized controlled studies on vitamin D metabolism, the significance of 25(OH)D deficiency, pathophysiological mechanisms, and the effects of supplementation. Included publications present the impact of vitamin D on endothelial function, oxidative stress, atherosclerosis, the neurohormonal system, glucose metabolism, and the risk of arrhythmia.

Results and Conclusions: A review of the literature indicates that vitamin D deficiency is associated with an increased risk of hypertension, heart failure, type 2 diabetes, atherosclerosis, and cardiac arrhythmias, including atrial fibrillation. The mechanisms of this effect include the action of VDR receptors in cardiomyocytes and vascular cells, modulation of the inflammatory response, reduction of oxidative stress, and regulation of the RAA system. Observational data suggest potential benefits of vitamin D supplementation, especially in high-risk groups, but large randomized clinical trials do not conclusively confirm that routine vitamin D administration reduces the number of major cardiovascular events in the general population. It is therefore necessary to individualize supplementation and conduct further well-designed studies to identify populations that may benefit most from therapy.

References

de la Guía-Galipienso, F., Martínez-Ferran, M., Vallecillo, N., Lavie, C. J., Sanchis-Gomar, F., & Pareja-Galeano, H. (2021). Vitamin D and cardiovascular health. Clinical Nutrition, 40(5), 2946–2957. https://doi.org/10.1016/j.clnu.2020.12.025

Renke, G., Starling-Soares, B., Baesso, T., Petronio, R., Aguiar, D., & Paes, R. (2023). Effects of vitamin D on cardiovascular risk and oxidative stress. Nutrients, 15(3), 769. https://doi.org/10.3390/nu15030769

Cosentino, N., Campodonico, J., Milazzo, V., et al. (2021). Vitamin D and cardiovascular disease: Current evidence and future perspectives. Nutrients, 13(10), 3603. https://doi.org/10.3390/nu13103603

Liu, L., Cui, S., Volpe, S. L., May, N. S., Sukumar, D., DiMaria-Ghalili, R. A., & Eisen, H. J. (2022). Vitamin D deficiency and metabolic syndrome: The joint effect on cardiovascular and all-cause mortality in the United States adults. World Journal of Cardiology, 14(7), 411–426. https://doi.org/10.4330/wjc.v14.i7.411

Giustina, A., Bilezikian, J. P., Adler, R. A., Banfi, G., Bikle, D. D., Binkley, N. C., Bollerslev, J., Bouillon, R., Brandi, M. L., Casanueva, F. F., di Filippo, L., Donini, L. M., Ebeling, P. R., Fuleihan, G. E., Fassio, A., Frara, S., Jones, G., Marcocci, C., Martineau, A. R., ... Virtanen, J. K. (2024). Consensus statement on vitamin D status assessment and supplementation: Whys, whens, and hows. Endocrine Reviews, 45(5), 625–654. https://doi.org/10.1210/endrev/bnae009

Abouzid, M., Burchardt, P., Kagan, L., Główka, F., & Karaźniewicz-Łada, M. (2024). Associations between vitamin D status, VDR gene polymorphisms and echocardiographic markers in Polish patients with cardiovascular disease. Future Cardiology, 20(3), 123–135. https://doi.org/10.2217/fca-2023-0129

Latic, N., & Erben, R. G. (2020). Vitamin D and cardiovascular disease, with emphasis on hypertension, atherosclerosis, and heart failure. International Journal of Molecular Sciences, 21(18), 6483. https://doi.org/10.3390/ijms21186483

Carbone, F., Liberale, L., Libby, P., & Montecucco, F. (2023). Vitamin D in atherosclerosis and cardiovascular events. European Heart Journal, 44(23), 2078–2094. https://doi.org/10.1093/eurheartj/ehad165

Giustina, A., Bilezikian, J. P., Adler, R. A., Banfi, G., Bikle, D. D., Binkley, N. C., Bollerslev, J., Bouillon, R., Brandi, M. L., Casanueva, F. F., di Filippo, L., Donini, L. M., Ebeling, P. R., Fuleihan, G. E., Fassio, A., Frara, S., Jones, G., Marcocci, C., Martineau, A. R., ... Virtanen, J. K. (2024). Consensus statement on vitamin D status assessment and supplementation: Whys, whens, and hows. Endocrine Reviews, 45(5), 625–654. https://doi.org/10.1210/endrev/bnae009

Driggin, E., Madhavan, M. V., & Gupta, A. (2022). The role of vitamin D in cardiovascular disease and COVID-19. Reviews in Endocrine and Metabolic Disorders, 23(2), 293–297. https://doi.org/10.1007/s11154-021-09674-w

Andrès, E., Lorenzo-Villalba, N., Terrade, J. E., & Méndez-Bailon, M. (2024). Fat-soluble vitamins A, D, E, and K: Review of the literature and points of interest for the clinician. Journal of Clinical Medicine, 13(13), 3641. https://doi.org/10.3390/jcm13133641

Bouillon, R. (2019). Vitamin D and cardiovascular disorders. Osteoporosis International, 30(11), 2167–2181. https://doi.org/10.1007/s00198-019-05098-0

Wang, X., Wang, J., Gao, T., Sun, H., & Yang, B. (2022). Is vitamin D deficiency a risk factor for all-cause mortality and rehospitalization in heart failure patients? A systematic review and meta-analysis. Medicine, 101(28), e29507. https://doi.org/10.1097/MD.0000000000029507

Yu, J., Sharma, P., Girgis, C. M., & Gunton, J. E. (2022). Vitamin D and beta cells in type 1 diabetes: A systematic review. International Journal of Molecular Sciences, 23(22), 14434. https://doi.org/10.3390/ijms232214434

Zittermann, A., Trummer, C., Theiler-Schwetz, V., Lerchbaum, E., März, W., & Pilz, S. (2021). Vitamin D and cardiovascular disease: An updated narrative review. International Journal of Molecular Sciences, 22(6), 2896. https://doi.org/10.3390/ijms22062896

Reina-Couto, M., Afonso, J., Carvalho, J., Morgado, L., Ronchi, F. A., de Oliveira Leite, A. P., Dias, C. C., Casarini, D. E., Bettencourt, P., Albino-Teixeira, A., Morato, M., & Sousa, T. (2021). Interrelationship between renin-angiotensin-aldosterone system and oxidative stress in chronic heart failure patients with or without renal impairment. Biomedicine & Pharmacotherapy, 133, 110938. https://doi.org/10.1016/j.biopha.2020.110938

Batty, M., Bennett, M. R., & Yu, E. (2022). The role of oxidative stress in atherosclerosis. Cells, 11(23), 3843. https://doi.org/10.3390/cells11233843

Libby, P., Buring, J. E., Badimon, L., Hansson, G. K., Deanfield, J., Bittencourt, M. S., Tokgözoğlu, L., & Lewis, E. F. (2019). Atherosclerosis. Nature Reviews Disease Primers, 5(1), 56. https://doi.org/10.1038/s41572-019-0106-z

Surdu, A. M., Pînzariu, O., Ciobanu, D. M., Negru, A. G., Căinap, S. S., Lazea, C., Iacob, D., Săraci, G., Tirinescu, D., Borda, I. M., & Cismaru, G. (2021). Vitamin D and its role in the lipid metabolism and the development of atherosclerosis. Biomedicines, 9(2), 172. https://doi.org/10.3390/biomedicines9020172

Khanolkar, S., Hirani, S., Mishra, A., Vardhan, S., Hirani, S., Prasad, R., & Wanjari, M. (2023). Exploring the role of vitamin D in atherosclerosis and its impact on cardiovascular events: A comprehensive review. Cureus, 15(7), e42470. https://doi.org/10.7759/cureus.42470

Liu, X., Wang, W., Tan, Z., Zhu, X., Liu, M., Wan, R., & Hong, K. (2019). The relationship between vitamin D and risk of atrial fibrillation: A dose-response analysis of observational studies. Nutrition Journal, 18(1), 73. https://doi.org/10.1186/s12937-019-0485-8

Ding, X., Lai, J., Zhang, H., & Guo, Z. (2023). Vitamin D, vitamin D supplementation and atrial fibrillation risk in the general population: Updated systematic review and meta-analysis of prospective studies. Frontiers in Nutrition, 10, 1246359. https://doi.org/10.3389/fnut.2023.1246359

Huang, W. L., Yang, J., Yang, J., Wang, H. B., Yang, C. J., & Yang, Y. (2018). Vitamin D and new-onset atrial fibrillation: A meta-analysis of randomized controlled trials. Hellenic Journal of Cardiology, 59(2), 72–77. https://doi.org/10.1016/j.hjc.2017.11.006

Ashraf, T., Moiz, M. A., Kumar, G., Kumar, A., Kumar, V., Anand, V., Sunita, F., Ladhwani, N. K., Hussain, T., Dev, S., Turesh, M., Bhutto, S. H., Ejaz, U., & Jawad, S. (2025). Vitamin D supplementation among postoperative atrial fibrillation in patients undergoing coronary artery bypass grafting: A systematic review and meta-analysis. Annals of Medicine and Surgery, 87(7), 4435–4441. https://doi.org/10.1097/MS9.0000000000003426

Grant, W. B., Wimalawansa, S. J., Pludowski, P., & Cheng, R. Z. (2025). Vitamin D: Evidence-based health benefits and recommendations for population guidelines. Nutrients, 17(2), 277. https://doi.org/10.3390/nu17020277

Argano, C., Mirarchi, L., Amodeo, S., Orlando, V., Torres, A., & Corrao, S. (2023). The role of vitamin D and its molecular bases in insulin resistance, diabetes, metabolic syndrome, and cardiovascular disease: State of the art. International Journal of Molecular Sciences, 24(20), 15485. https://doi.org/10.3390/ijms242015485

Thompson, B., Waterhouse, M., English, D. R., McLeod, D. S., Armstrong, B. K., Baxter, C., Duarte Romero, B., Ebeling, P. R., Hartel, G., Kimlin, M. G., Rahman, S. T., van der Pols, J. C., Venn, A. J., Webb, P. M., Whiteman, D. C., & Neale, R. E. (2023). Vitamin D supplementation and major cardiovascular events: D-Health randomised controlled trial. BMJ, 381, e075230. https://doi.org/10.1136/bmj-2023-075230

Pei, Y. Y., Zhang, Y., Peng, X. C., Liu, Z. R., Xu, P., & Fang, F. (2022). Association of vitamin D supplementation with cardiovascular events: A systematic review and meta-analysis. Nutrients, 14(15), 3158. https://doi.org/10.3390/nu14153158

Bilezikian, J. P., Formenti, A. M., Adler, R. A., Binkley, N., Bouillon, R., Lazaretti-Castro, M., Marcocci, C., Napoli, N., Rizzoli, R., & Giustina, A. (2021). Vitamin D: Dosing, levels, form, and route of administration: Does one approach fit all? Reviews in Endocrine and Metabolic Disorders, 22(4), 1201–1218. https://doi.org/10.1007/s11154-021-09693-7

McKenna, M. J., & Flynn, M. A. T. (2023). Preventing type 2 diabetes with vitamin D: Therapy versus supplementation. Annals of Internal Medicine, 176(3), 415–416. https://doi.org/10.7326/M23-0220

Cortese, F., Costantino, M. F., Luzi, G., Di Marino, S., Giordano, P., & Monitillo, F. (2022). Vitamin D and cardiovascular disease risk. A literature overview. Molecular Biology Reports, 49(9), 8925–8942. https://doi.org/10.1007/s11033-022-07373-6