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How to improve the effectivity of treatment of cardiovascular diseases


Authors: H. Matějovská Kubešová;  B. Vepřeková;  P. Weber;  K. Bielaková;  T. Gregorová
Authors‘ workplace: Klinika interní, geriatrie a praktického lékařství, LFMU a FN Brno 1;  Nemocnice Milosrdných Bratří, Brno 2
Published in: Geriatrie a Gerontologie 2012, 1, č. 2: 81-84
Category: Review Article

Overview

Therapy of cardiac failure, hypertension or arrythmias is frequently not so effective in elderly. This could be cause by long term defficiency of vitamin D. Lot of attention is paid to vitamin D in last few years due to brighter spectrum of influence in human organs. As a main mechanism of action are proved vitamin nuclear D receptors (VDR). More and more evidence of negative influence of vitamin D deficit on cardiovascular system appears together with low vitamin D serum levels in current population mostly due to live style with little exposition of unprotected skin to sun beams.

The course of ischemic heart disease can be worsened by low serum level of vitamin D because of higher risk of myocardial infarction, a cardiac failure with more frequent hospitalisations. Higher risk of arrythmias during vitamin D deficiency is explained by higher production of parathormone and its binding to receptors stimulating phospholipase C followed by higher activity of catecholamines, angiotensin II and endothelin in ischaemic myocardium. There is no evidence of any association of vitamin D and cholesterol levels, on the other hand normal level of vitamin D helps to keep the triglyceride serum concentration in normal range. Hypertension is influenced negatively by low level of vitamin D by stimulation of renin-angiotensin-aldosteron system, parathormon secretion and lower antiiflammatory and vasculoprotective effect. Conclusion. The course of cardiovascular diseases can be positively modulated by keeping of vitamin D level within normal range. The adequate exposition on unprotected skin to sun is to recommend for the supplementation as a nature and effective source of vitamin D.

Key words:
hypertension – ischaemic heart disease – cardiac failure – arrythmias – vitamin D


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