A Personalized Approach to Vitamin D Supplementation in Cardiovascular Health Beyond the Bone: An Expert Consensus by the Italian National Institute for Cardiovascular Research
Anna Vittoria Mattioli, Francesca Coppi, Paolo Severino, Cláudia Penna, Pasquale Pagliaro, Alessandra Dei, Valentina Bucciarelli, Rosalinda Madonna, Cantor Tarperi, Federico Schena, Silvia Cetrullo, Tommaso Angelone, Carmine Rocca, Astrid Parenti, Alberto Palazzuoli, Alberto Margonato, Stefania Paolillo, Pasquale Perrone Filardi, Francesco Barillà, Carlo Lombardi, Marcello Pinti, Claudio Molinari, Antonio Cevese, Giuseppina Novo, Carmine Pizzi, Italo Porto, Corrado Poggesi, Sabina Gallina, Giuseppe Ambrosio, Francesco Fedele
Abstract
Vitamin D is increasingly recognized for its role in cardiovascular health beyond its well-established effects on bone metabolism. This review synthesizes findings from observational studies, interventional trials, and meta-analyses to clarify the mechanisms through which vitamin D impacts cardiovascular health, including its influence on vascular function, inflammation, and metabolic pathways. Additionally, this review emphasizes the importance of a personalized approach to vitamin D supplementation, integrating individual cardiovascular risk profiles, baseline vitamin D levels, and comorbid conditions, such as hypertension and diabetes. While current evidence supports the association between low vitamin D levels and increased cardiovascular mortality, this work contributes novel insights by proposing tailored strategies for supplementation, particularly for high-risk subgroups. Practical recommendations for implementing these strategies in clinical practice are also discussed, providing a framework for optimizing cardiovascular outcomes through individualized vitamin D management.