Date of Graduation

Summer 8-2012

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

Mark Pedemonte, MD

Second Advisor

Annjanette Sommers PA-C, MS

Abstract

Background: There is growing concern that chronic hypovitaminosis D at levels below 30ng/ml may negatively contribute to several major diseases of the developed world to include diabetes, cardiovascular disease, and cancer. According to the CDC approximately 80% of African Americans > 1 years of age suffer from vitamin D insufficiency. The clinical question that will be explored in the following literature review is, whether hypovitaminosis D in the African American population contributes to increase incidents of vascular disease.

Methods: An extensive literature search was conducted in the databases of MEDLINE, CINAHL, Web of Science, and Google Scholar. Articles were selected that specifically studied the African American population and assessed the relationship of vitamin D and vascular disease in that group.

Results: All four articles found were cross-sectional in nature and therefore ranked “low” in quality of evidence. Two studies used data from the National Center for Health Statistics and found an independent inverse correlation between vitamin D levels and peripheral artery disease. A third study of ESRD patients looked at the relationship between MMP-9, (a biomarker for vascular disease), and vitamin D levels and found an inverse correlation. There was a positive correlation found in the study by Freedman et al. in regards to vitamin D level and calcified atherosclerotic plaques (CP) in the carotid and infrarenal aorta, with no association found between vitamin D and CP in the coronary vessels.

Conclusion: The findings deduced in this study, suggest that, there is not definitive data that supports as to whether hypovitaminosis D negatively affects vascular health in African-Americans. It is well understood that correlation does not imply causation. There is a need for longitudinal studies as well as random control trials.

Keywords: Vitamin D, African American, Vascular disease, Peripheral Artery Disease, and Cardiovascular disease.

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