ASSOCIATION BETWEEN VITAMIN D LEVEL AND ESSENTIAL HYPERTENSION
DOI:
https://doi.org/10.22159/ajpcr.2023.v16i10.49327Keywords:
Blood pressure, Essential hypertension, Intimal thickness, Vitamin D, Ventricular massAbstract
Objective: There is relationship between vitamin D deficiency and hypertension (HTN). The mechanism causing the development of HTN, the Renin Aldosterone Angiotensin System, was discovered to be strongly inhibited by vitamin D. This study was piloted to assess the role of vitamin D deficiency in the development of essential hypertension (EH).
Methods: A total of 50 patients with EH and 50 healthy participants participated in this study. Every participant was subjected to clinical history, physical examination, and other necessary blood testing, electrocardiography, and echocardiography.
Results: There was a significant decrease in vitamin D in hypertensive group (20.25±3.28 ng/mL) than normotensive group (38.33±6.89 ng/mL). Vitamin D level was moderately negative correlated with systolic blood pressure (BP) (r – 0.43, p – 0.001), strong negative correlation with diastolic BP (r – 0.76, p<0.001), strong negative correlation with intimal thickness (r – 0.67, p<0.001), and moderate negative correlation with ventricular mass (r – 0.48, p<0.001). Intimal thickness and ventricular mass were significantly higher in patients with EH with low vitamin D than those with normal vitamin D levels.
Conclusion: There is a strong inverse relationship between serum vitamin D and HTN. Vitamin D deficiency levels are considered an additional risk factor for cardiovascular morbidity and mortality.
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References
Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: A cross-sectional study. BMJ Open 2013;3:e003423. doi: 10.1136/ bmjopen-2013-003423, PMID 23996822
Chen S. Essential hypertension: Perspectives and future directions. J Hypertens 2012;30:42-5. doi: 10.1097/HJH.0b013e32834ee23c, PMID 22157586
Rostand SG. Vitamin D, blood pressure, and African Americans: toward a unifying hypothesis. Clin J Am Soc Nephrol 2010;5:1697-703.
Rostand SG. Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension 1997;30:150-6. doi: 10.1161/01.hyp.30.2.150, PMID 9260973
Jayedi A, Rashidy-Pour A, Shab-Bidar S. Vitamin D status and risk of dementia and Alzheimer’s disease: A meta-analysis of dose-response. Nutr Neurosci 2019;22:750-9. doi: 10.1080/1028415X.2018.1436639, PMID 29447107
Zhang R, Li B, Gao X, Tian R, Pan Y, Jiang Y, et al. Serum 25-hydroxyvitamin D and the risk of cardiovascular disease: Dose-response meta-analysis of prospective studies. Am J Clin Nutr 2017;105:810-9. doi: 10.3945/ajcn.116.140392, PMID 28251933
Ekmekcioglu C, Haluza D, Kundi M. 25-hydroxyvitamin D status and risk for colorectal cancer and Type 2 diabetes mellitus: A systematic review and meta-analysis of epidemiological studies. Int J Environ Res Public Health 2017;14:E127. doi: 10.3390/ijerph14020127, PMID 28134804
Chen S, Sun Y, Agrawal DK. Vitamin D deficiency and essential hypertension. J Am Soc Hypertens 2015;9:885-901. doi: 10.1016/j. jash.2015.08.009, PMID 26419755
Golzarand M, Shab-Bidar S, Koochakpoor G, Speakman JR, Djafarian K. Effect of Vitamin D3 supplementation on blood pressure in adults: An updated meta-analysis. Nutr Metab Cardiovasc Dis 2016;26:663-73. doi: 10.1016/j.numecd.2016.04.011, PMID 27287826
Beveridge LA, Struthers AD, Khan F, Jorde R, Scragg R, Macdonald HM, et al. Effect of Vitamin D supplementation on blood pressure: A systematic review and meta-analysis incorporating individual patient data. JAMA Intern Med 2015;175:745-54. doi: 10.1001/jamainternmed.2015.0237, PMID 25775274
Kunutsor SK, Burgess S, Munroe PB, Khan H. Vitamin D and high blood pressure: causal association or epiphenomenon Eur J Epidemiol 2014;29:1-14. doi: 10.1007/s10654-013-9874-z, PMID 24374742
Kunutsor SK, Apekey TA, Steur M. Vitamin D and risk of future hypertension: Meta-analysis of 283,537 participants. Eur J Epidemiol 2013;28:205-21. doi: 10.1007/s10654-013-9790-2, PMID 23456138
Institute of Medicine Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: The National Academies Press; 2011.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr., et al. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: The JNC 7 report. JAMA 2003;289:2560-72. doi: 10.1001/ jama.289.19.2560, PMID 12748199
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of Vitamin D deficiency: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011;96:1911-30. doi: 10.1210/jc.2011-0385, PMID 21646368
Purari S, Singh R, Kumar S, Kishore K. Study on co-relation between serum Vitamin D level and essential hypertension. Int J Pharm Clin Res 2023;15:653-63.
Ahmad YK, El-Ghamry EM, Tawfik S, Atia W, Keder M, Abd-El Kader S. Assessment of Vitamin D status in patients with essential hypertension. Egypt J Hosp Med 2018;72:4434-8.
Clemens TL, Adams JS, Henderson SL, Holick MF. Increased skin pigment reduces the capacity of skin to synthesise Vitamin D3. Lancet 1982;1:74-6. doi: 10.1016/s0140-6736(82)90214-8, PMID 6119494
Alpsoy S, Akyüz A, Akkoyun DC, Gür DÖ, Topcu B, Tülübas F. Vitamin D levels in white coat and sustained hypertension. Blood Press Monit 2016;21:131-5. doi: 10.1097/MBP.0000000000000171, PMID 26735704
Andreassen TK. The role of plasma-binding proteins in the cellular uptake of lipophilic vitamins and steroids. Horm Metab Res 2006;38:279-90. doi: 10.1055/s-2006-925348, PMID 16700010
Guessous I, Bochud M, Bonny O, Burnier M. Calcium, Vitamin D and cardiovascular disease. Kidney Blood Press Res 2011;34:404-17. doi: 10.1159/000328332, PMID 21677437
Rueda S, Fernández-Fernández C, Romero F, Martínez de Osaba J, Vidal J. Vitamin D, PTH and the metabolic syndrome in severely obese subjects. Obes Surg 2008;18:151-4. doi: 10.1007/s11695-007-9352-3, PMID 18175193
Reis J, Von Muhien D, Kritz D, Wingard L, Barrett E. Vitamin D, PTH levels and prevalence of metabolic syndrome in community dwelling older adults. Diabetes Care 2007;30:1549-55.
Kendrick J, Targher G, Smits G, Chonchol M. 25-Hydroxyvitamin D deficiency is independently associated with cardiovascular disease in the Third National Health and Nutrition Examination Survey. Atherosclerosis 2009;205:255-60. doi: 10.1016/j. atherosclerosis.2008.10.033, PMID 19091317
Roy A, Lakshmy R, Tarik M, Tandon N, Reddy KS, Prabhakaran D. Independent association of severe Vitamin D deficiency as a risk of acute myocardial infarction in Indians. Indian Heart J 2015;67:27-32. doi: 10.1016/j.ihj.2015.02.002, PMID 25820047
El-Menyar A, Rahil A, Dousa K, Ibrahim W, Ibrahim T, Khalifa R, et al. Low Vitamin D and cardiovascular risk factors in males and females from a sunny, rich country. Open Cardiovasc Med J 2012;6:76-80. doi: 10.2174/1874192401206010076, PMID 22833770
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Copyright (c) 2023 DR. KOMAL BHARTI SINGLA1, DR. SNEHA PATIL2, DR. HIMANSHUKUMAR PATEL3, DR. KENA PATEL4*
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