April 8, 2011

Reduced vitamin D levels linked to arterial stiffness

A presentation by Ibhar Al Mheid, MD at the annual American College of Cardiology meeting on April 2, 2011 revealed the finding of Emory University School of Medicine researchers of a protective effect for vitamin D against arterial stiffness and impaired blood vessel relaxation.

Dr Al Mheid, along with Emory Cardiovascular Research Institute director Arshed Quyyumi, MD, evaluated data from 554 participants in the Emory/Georgia Tech Predictive Health Institute's Center for Health Discovery and Well Being. Endothelial function was evaluated via brachial artery flow-mediated dilation, and microvascular function and arterial stiffness were assessed. Blood samples were analyzed for serum 25-hydroxyvitamin D, a stable form of the vitamin that reflects dietary intake and skin production.

The participants' levels of vitamin D averaged 31.8 nanograms per milliliter (ng/mL). Thirty-three percent had insufficient levels of less than 30 ng/mL, and 14 percent were deficient at levels of less than 20 ng/mL. Reduced levels of vitamin D correlated with increased arterial stiffness and vascular function impairment. Among those whose vitamin D levels were normalized over a six month period, vascular health improved and blood pressure measurements declined. "We found that people with vitamin D deficiency had vascular dysfunction comparable to those with diabetes or hypertension," Dr Al Mheid observed.

"There is already a lot known about how vitamin D could be acting here," he remarked. "It could be strengthening endothelial cells and the muscles surrounding the blood vessels. It could also be reducing the level of angiotensin, a hormone that drives increased blood pressure, or regulating inflammation."

"This was an observational study, rather than an interventional one, and it was difficult to tease out how the people who restored their vitamin D levels got there," he noted. "We are hoping to conduct a study where we have participants take a defined regimen of vitamin D."

"With his findings showing the relationship between vitamin D deficiency and vascular dysfunction, Dr Mheid has helped advance our understanding of the importance of Vitamin D in preventing a common health problem in aging adults," acknowledged Kenneth Brigham, MD, who is the medical director of the Emory/Georgia Tech Center for Health Discovery and Well Being. "Additionally, ongoing health studies based on the Center's collection of health information from participants will yield more discovery as the Center continues to develop."

Atherosclerosis and cardiovascular disease

Despite the fact that cardiovascular disease is the single most deadly disease in the United States, most individuals, including most mainstream physicians, have a flawed fundamental understanding of the disease. The fact is, long before any symptoms are clinically evident, vascular disease begins as a malfunction of specialized cells that line our arteries. These cells, called endothelial cells, are the key to atherosclerosis and underlying endothelial dysfunction is the central feature of this dreaded disease.

Experiments have shown that the benefits of resveratrol include improvements in the health of the endothelial tissue lining blood vessels (Balestrieri, 2007; Ungvari, 2007; Wang, 2007; Ballard, 2007). One mechanism by which it does this is to facilitate the generation of endothelial progenitor stem cells, thereby providing the endothelium with fresh new cells.

Resveratrol benefits the circulatory system by eliciting a decrease in the oxidation of low-density lipoprotein (LDL); by fostering decreases in platelet aggregation; and by promoting relaxation of small blood vessels called arterioles (Nissen, 2006; Taylor, 2002; Crouse, 2007; Cloarec, 2007). Collectively, these mechanisms benefit the overall health of the cardiovascular system by decreasing factors that contribute to the development of atherosclerosis, and by decreasing the likelihood of undesirable clotting, which, in turn, decreases the risk of stroke (Opie, 2007). Furthermore, data indicate that resveratrol decreases the incidence of dangerous heart arrhythmias (Chen, 2007).

In spontaneously hypertensive rats, quercetin, along with other bioflavonoids, preserved endothelial function by increasing nitric oxide and reducing blood pressure (Machha, 2005).

A porcine study showed that quercetin has potent antioxidative properties and protects endothelial cells against induced dysfunction (Reiterer, 2004). Quercetin and resveratrol may work particularly well together.

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