Published online May 26, 2014. doi: 10.4330/wjc.v6.i5.260
Revised: March 24, 2014
Accepted: April 11, 2014
Published online: May 26, 2014
Processing time: 223 Days and 21.3 Hours
Vitamin D deficiency has been indicated as a pandemic emerging public health problem. In addition to the well-known role on calcium-phosphorus homeostasis in the bone, vitamin D-mediated processes have been recently investigated on other diseases, such as infections, cancer and cardiovascular diseases. Recently, both the discovery of paracrine actions of vitamin D (recognized as “local vitamin D system”) and the link of vitamin D with renin-angiotensin-aldosterone system and the fibroblast growth factor 23/klotho pathways highlighted its active cardiovascular activity. Focusing on hypertension, this review summarizes the more recent experimental evidence involving the vitamin D system and deficiency in the cardiovascular pathophysiology. In particular, we updated the vascular synthesis/catabolism of vitamin D and its complex interactions between the various endocrine networks involved in the regulation of blood pressure in humans. On the other hand, the conflicting results emerged from the comparison between observational and interventional studies emphasize the fragmentary nature of our knowledge in the field of vitamin D and hypertension, strongly suggesting the need of further researches in this field.
Core tip: This review provides a comprehensive and critical analysis of the most recent studies investigating the relationship between vitamin D and essential hypertension. From the both observational and interventional studies, conflicting results have been shown. This review article provides some hypothesis to explain these discrepancies. In addition to the potential bias related to the study design, some pathophysiological explanation was suggested, especially involving the potential role of local vitamin D system as well as the fibroblast growth factor 23/klotho axis. This review aims at suggesting a careful reflection so that future studies might be designed for minimize bias and encompass the complex biology of vitamin D system.