factors can be modified such as lifestyle. (1). A healthy lifestyle has main elements including mainly following a suitable diet that can boost the cardiovascular state and it should maintain vitamins that can help the blood vessels and heart and make them work effectively. Vitamins can have a great role in prevention against the CVD and in particular those having antioxidant potency as they can be therapy. Vitamins which are antioxidant include vitamin C, E as well as carotenoids and they are all capable of reducing the oxidative level that can have a main role in CVD and atherosclerosis' pathogenesis. Vitamin D is relevant to cardiovascular health and is able to leave protective impact in that case. (1) fish and seafood are important as food in addition to fermented soybeans and vegetables and fruits as they can reduce the CVD risk and effects of heart attack because they maintain high amount of fat soluble vitamins (A, E, D and K). Seafood including fish have the main content of vitamin D needed for the protection of the body, another needed element can be gained from soybeans which is vitamin K, A and E too that are important and can also be found through having vegetables and fruits. (2) There are also other vitamins that are needed on the CV system health such as the water soluble vitamins B and C as for example, vitamin B1 can cause congestive heart failure if there is shortage in it (3) while vitamin B2 deficiency can lead to diseases such as CVD and others in addition to biochemical pathways irregularities (4). There are high risk for CVD mortality associated with low consumption of vitamin B6 (5) there are positive effects of vitamin C on the cardiovascular risk factors too. (6).
Vitamin B1
Thiamine is a vitamin that is necessary for multicellular organisms work and it is a water-soluble one that is important for the process of carbohydrate metabolism. Thiamine deficiency can have complications such as damage in the cells which is hyperglycemic induced and undergoes dysfunction in addition to high oxidative stress. When there is deficiency in thiamine, metabolism occurs into other pathways which can lead to vascular damage. (3) there are some relevant mechanisms for deficiency of thiamine in heart failure such as (a) reduced intake of thiamine with splanchnic congestion and cardiac cachexia, (b) high rates of urinary excretion that is relevant to the diuretics usage and (C) altered thiamine metabolism. Thiamine raised urinary excretion in the patients who suffer heart failure and have loop diuretics at high-doses as furosemide which is considered the most necessary factor that relates to deficiency of thiamine in those patients. (figure) (8).
Vitamin B2
Riboflavin is distinguished among other water-soluble vitamins which can be found in milk and other dairy products which is almost considered in Western diets and is included mainly in them. Fish and meat are considered sources for riboflavin and it can also be found in certain fruits and vegetables especially those dark green ones. depletion arise has biochemical signs that happen within days of deprivation of the diet. (10) There are high amounts of riboflavin in the human heart which can be referred to as RF or vitamin B2 and is important for having normal function, structure and cellular physiology. Yet, the mammals have cardiac muscle cells that are devoid of the capacity to synthesize RF and can depend totally on sources of exogenous dietary that can transmit among cell membrane. Although RF is important, there is lack of knowledge about the molecular mechanisms which organize the process of RF uptake and its transporters in the cardiovascular system (4). RF is existing in many different biochemical pathways, there can be unusual metabolic products accumulation such as the homocysteine that is an example for amino acid associated in Parkinson's pathogenesis as well as Alzheimer which is also risky for cardiovascular problems. (4)
Vitamin C
Vitamin C is an important nutrient that includes special antioxidant features. When the human intakes bigger amounts of vitamin C, this reduces risk on the heart and cardiovascular risk. (6) Diets that are high in vitamin C are usually depending on vegetables and fruits as this reduces CVD risk. Vitamin C has a physiological role and its collagen form in addition to being antioxidant make it effective in facing CVD. Higher intake of the vitamin provides plausible underpinning mechanisms that can modulate CVD pathogenesis (6) (figure) In the risk development of the coronary artery in the young adult study, there is a relationship between the high existence of vitamin C in plasma and low risk of hypertension (hazard ratio estimated with: 0.85, 95% CI: 0.79-0.92). In addition to this, it is important to take vitamin C from basic food and drinks and not from supplements in order to reduce the risk of hypertension development. (6)
Fat Soluble vitamins
Higher fat-soluble vitamin intakes such as D in particular can aid in the improvement of cardiac function, contractility and hypertrophy and its lower intakes can lead to heart failure risk factors including diabetes and coronary heart disease and others as hypertension or atherosclerosis. Some studies state that antioxidants high intakes can have effective role for heart failure risk but other studies suggest that vitamins E and D as supplements can do nothing relevant to heart failure or may not have significant effect on the long term. (2)
Vitamin K is a vitamin that is fat-soluble and has a role in the blood coagulation as it was first known in 1939 by Henrick Dam who referred its name to the clotting koagulation blood word (9) Vitamin K can be included within our daily diet in green leaves which is its first form K1 or phylloquinone and there is K2 or (menaquinones) that can be found basically in dairy, meat and soybeans. K2 has many other vitamin forms that are ifferent in the length of their side-chain and saturation degree. K2 is another form of the vitamin and it is the most active biologically. (9)
There are studies that show the role of low vitamin K status in causing cardiovascular disease and its development too especially when there is high risk and among people suffering kidney disease. (9) Another risk factor for the death by cardiovascular is vascular calcification. (18) There can be arterial stiffing caused by calcification occurring in the vasculature. (19) Vascular calcification has not cure till now and it is only treatment for symptom. This makes it important to understand all mechanisms related to the disease. (9)
Vitamin E is an important vitamin which is fat-soluble antioxidant and it contain alpha-tocopherol in its active form. Oxidation is an important part of atherogenesis. Inflammatory markers can be produced in the endothelial cells by oxidized low density lipoprotein and it is found in the cell formation foam. There are toxic impact on the endothelial cells which can inhibit the vasodilatation. Vitamin E was found to raise the oxidative resistance in the vitro and stop any formation of atherosclerotic plaque in mouse models. (10) Vitamin E supplementation might be relevant to mortality, hemorrhagic stroke and heart failure as the American Heart Association doesn't suggest it for heart failure as a supplementation but it advises it as in food consumption. (10)
Vitamin B12 is able to help the human body have healthy nerve and blood as it helps in making the genetics and DNA in the cells. Vitamin B12 can stop anemia form called megaloblastic which can cause fatigue to people and weakens their ability. (12) Vegetarians usually lack vitamin B12 which leads to many atherogenic processes that is referred to as hyperhomocysteinemia. Each 5-μmol/L that go over serum homocysteine μmol/L that is relevant to circulatory health problems and its high risk. (11) Mean of concentration of homocysteine >10 μmol/L in the vegetarians was found in 32 of 34 reported cases. Deficiency of vitamin B12 is associated with coronary disease that is fatal or not and with Macrocytosis too and cases as stroke and myocardial infarction and others. This raises risk factor at the vegetarians of having heart diseases and its risk factors such as blood pressure, serum lipids and weight problems. (11)
Deficiency in vitamin B6 can't easily be found today among medical practices but it is thought to be common within people who have many different conditions such as elderly or alcohol addicts. (13) Studies suggest that reduced dietary intake of vitamin B6 and its low concentration in the blood can lead to high cardiovascular disease and this is proved too by case control Epidemiologic evidence. Yet, there are trials made recently that proved no effectiveness for vitamin B6 as supplementation in cases of cardiovascular prevention. As a result of the weak limited data about the relevance of vitamin B6 with critical functions of human body, this made a challenge of trying to make a relationship of cause and reason between the cardiovascular disease risk and the vitamin B6 which can identify this mechanism that the vitamin can be affecting that risk. The current chapter there is a review for knowledge related to the mechanisms associating vitamin B6 and the cardiovascular risk and the development of the disease. (13)
Vitamin A can associate many body processes such as health of the skin, sight of the eye and others but its relevant to the health of heart is not clear yet. Vitamin A is critical for development of the heart and its deficiency can cause to heart problems in pregnancy and may lead to death. The studies made on its role leads to opposite results and there is a new study found in the American Journal Physiology as it supposes that there is a capability for the heart to respond to vitamin A and this relies on its amount but such effect is not said to be good or bad.
There is an investigation made by the multi-institutional research team about vitamin A role on the health of the heart through examination of the receptors of the retinoic acid in the heart and the events occurring to the heart at time of being a deficient body of the vitamin A. The results showed that there is retinoic acid receptor protein in the heart that can have a respond to Vitamin A. The researchers tried to make a diet with deficiency in Vitamin A that is presented to genetically modified mice which are able to store the vitamin in their livers. They found that vitamin A stores that are reduced can change the way the heart can maintain itself. The mice that are genetically modified hearts were having the same size and shape of the normal mice but they expressed genes that are different. GM mice included more cells that have the ability to exchange and replace the heart cells that are damaged and less damage was shown in them after they had heart attack that is surgically induced even when the diet they were following included Vitamin A.
