Graphical Abstract.

Pleiotropic effects of vitamin D on the cardiovascular system. Sunlight exposure, exogenous dietary, and pharmacological supply primarily determine vitamin D levels. Vitamin D is then stored within the adipose tissue which influences its systemic availability. Pleiotropic vitamin D effects on the cardiovascular system are mediated by intracellular vitamin D receptor or other transmembrane receptors and include beneficial modulation of senescence, inflamm-ageing, and adiposopathy. Clinical translation of such findings still requires more complete preclinical evidence, especially on newly defined mechanisms such as epigenetic senescence, and also better standardization among clinical studies (e.g. definition of deficiency, distinctions between fortified food and pharmacologic supplementation).