Low serum 25-hydroxyvitamin D levels are associated with increased cardiovascular morbidity and mortality

Background There is controversy about the association between vitamin D and cardiovascular disease (CVD). This article aims to explore the association of serum 25-hydroxyvitaminD (25 OHD) with the risk of CVD.Methods PubMed, EMBASE, Web of Science database, OVID, and Cochrane Library databases (last updated in August 2022) were systematically searched. The relationship between 25OHD and the risk of CVD was assessed by using the 95% confidence intervals (CI) and hazard ratio (HR). The effect model was selected by the size of heterogeneity.Results The meta-analysis included 40 cohort studies that contained 652352 samples. The pooled results showed that a decreased level of 25OHD was associated with an increased relative risk of total CVD events (HR = 1.35, 95% CI: 1.26–1.43). Furthermore, the results also showed that a decreased circulating 25OHD level was associated with an increased mortality of CVD (HR = 1.43, 95% CI: 1.30–1.57) and incidence of CVD (HR = 1.26, 95% CI: 1.16–1.36), especially an increased risk of heart failure (HF) (HR = 1.38, 95% CI: 1.2–1.6), myocardial infarction (MI) (HR = 1.28, 95% CI: 1.13–1.44) and coronary heart disease (CHD) (HR = 1.28, 95% CI: 1.1–1.49).Conclusions The current meta-analysis shows that reduced serum 25OHD concentrations is not only associated with increased total cardiovascular events and cardiovascular mortality, but also with increased risk of HF, MI, and CHD.Limitations The underlying mechanism still needs to be explored further, and well-designed RCTs are needed to confirm the role of vitamin D in the occurrence and development of CVD.