Cholecalciferol Treatment to Reduce Blood Pressure in Older Patients With Isolated Systolic HypertensionThe VitDISH Randomized Controlled Trial
JAMA Intern Med. 2013;():-. doi:10.1001/jamainternmed.2013.9043.
Miles D. Witham, PhD1; Rosemary J. G. Price, MSc1; Allan D. Struthers, MD2; Peter T. Donnan, PhD3; Claudia-Martina Messow, PhD4; Ian Ford, PhD4; Marion E. T. McMurdo, MD1
Importance Observational data link low 25-hydroxyvitamin D levels to both prevalent blood pressure and incident hypertension. No clinical trial has yet examined the effect of vitamin D supplementation in isolated systolic hypertension, the most common pattern of hypertension in older people.
Objective To test whether high-dose, intermittent cholecalciferol supplementation lowers blood pressure in older patients with isolated systolic hypertension.
Design Parallel group, double-blind, placebo-controlled randomized trial.
Setting Primary care clinics and hospital clinics.
Participants Patients 70 years and older with isolated systolic hypertension (supine systolic blood pressure >140 mm Hg and supine diastolic blood pressure <90 mm Hg) and baseline 25-hydroxyvitamin D levels less than 30 ng/mL were randomized into the trial from June 1, 2009, through May 31, 2011.
Interventions A total of 100 000 U of oral cholecalciferol or matching placebo every 3 months for 1 year.
Main Outcomes and Measures Difference in office blood pressure, 24-hour blood pressure, arterial stiffness, endothelial function, cholesterol level, insulin resistance, and b-type natriuretic peptide level during 12 months.
Results A total of 159 participants were randomized (mean age, 77 years). Mean baseline office systolic blood pressure was 163/78 mm Hg. Mean baseline 25-hydroxyvitamin D level was 18 ng/mL. 25-Hydroxyvitamin D levels increased in the treatment group compared with the placebo group (+8 ng/mL at 1 year, P < .001). No significant treatment effect was seen for mean (95% CI) office blood pressure (−1 [−6 to 4]/−2 [−4 to 1] mm Hg at 3 months and 1 [−2 to 4]/0 [−2 to 2] mm Hg overall treatment effect). No significant treatment effect was evident for any of the secondary outcomes (24-hour blood pressure, arterial stiffness, endothelial function, cholesterol level, glucose level, and walking distance). There was no excess of adverse events in the treatment group, and the total number of falls was nonsignificantly lower in the group receiving vitamin D (36 vs 46, P = .24).
Conclusions and Relevance Vitamin D supplementation did not improve blood pressure or markers of vascular health in older patients with isolated systolic hypertension.
Trial Registration isrctn.org Identifier: ISRCTN92186858
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Vitamin D prevents or treats 94 health problems
ADHD, Alcoholic Liver Cirrhosis, ALS, Alzheimer's, Antibiotic Use in Seniors, Asthma, Autism, Autoimmune Diseases, Back pain, Blood Cell Cancer, Breast Cancer, Cardiovascular, Cholesterol, Chronic Hives, Chronic Kidney Disease, Cluster Headaches, Congestive Heart Failure (Infants), COPD, Crohn's Disease, C-Section and Pregnancy Risks, Cystic Fibrosis, Depression, Diabetes, Diabetic Neuropathy, Eczema, Falls, Fatigue, Fatty Liver (Child), Fibromyalgia, Gestational Diabetes, Gingivitis, Growing Pains, Hay Fever, Heart Attack, Hemodialysis, Hepatitis-C, Hip Fractures, Hypertension, Influenza, Irritable Bowel Syndrome, Ischemic Stroke, Knee Osteoarthritis, Leg Ulcers, Low Birth Weight, Lupus, Male Infertility, Menstrual Pain, Metabolic Syndrome, Middle Ear Infection (Infants), Mite Allergy, Multiple Sclerosis, Non-Alcoholic Fatty Liver Disease, Osteoarthritis, Parkinson's Disease, Perinatal Depression, Pneumonia (Ventilator-associated), Poor Sleep, PreDiabetes, Preeclampsia, Pre-term Birth, Prostate Cancer, Quality of Life, Raynaud's Pain, Respiratory Tract Infection, Restless Leg Syndrome, Rheumatoid Arthritis, Rickets, Sarcopenia, Sepsis, Short Neonates, Sickle Cell, Stronger Senior Muscles, Survive ICU, TB, Tonsillitis, Trauma Death, Traumatic Brain Injury, Tuberculosis, Ulcerative Colitis, Urinary Tract Infection, Vaginosis, Vertigo, Warts, Weight LossReminder: Translate icon in the upper right selects a different language
Click on underlined items for detailsHealth Problem Treat
PreventReduction by Vit D RCT = Randomized Controlled Trial
* = link to additional RCT
CT = Clinical TrialHypertension T
P149 to 142 mm Hg
HT risk reduced 10XRCT* *, 2400 IU. 100,000 IU*
When Vitamin D > 40 ngCardiovascular after attack T 32 % fewer deaths CT 1000 IU Diabetes Type 1 P 85 % 12,000 kids, 2000 IU Diabetes Type 2 T 62 % RCT* CRP reduction, 4000 IU
Injection is far better - RCT *
RCT 50,000 IU/2weeks + probiotics
RCT 5,000 IU daily 6 monthsBack Pain T 95 %
reduced 50%5000/10000 IU
60,000 IU weeklyInfluenza P 90 % RCT *, 2000 IU Falls P 50% RCT, 100,000 IU monthly
RCT with Meals on Wheels 2016Hip Fractures P 30 % RCT * 800 IU Rickets P 98 % Turkey, 400 IU
NOT RCT, given to all childrenRaynaud's Syndrome T 40 % RCT, visual scale, 20000 IU Avg Menstrual pain P 76 % RCT, 7000 IU Avg,
70% reduction 2018
PMS reduced by halfPregnancy risks P 50 % RCT, 4000 IU C-section, unplanned P 50 % RCT, 4000 IU, small study Low birth weight P 60 % RCT * 1000 IU of D2 TB P 60 % RCT, 800 IU Breast Cancer P 60 % RCT, 1100 IU (2007) Rheumatoid Arthritis pain T 40 % RCT, 500 IU, added to prescription Cystic Fibrosis T 75 %
2nd study improvedRCT, pilot 4X fewer deaths 250,000 IU
RCT, pilot 8,200 IUChronic Kidney T 90 to 70 PTH RCT, 3500 IU, Respiratory Tract Infection P 63 % 3 RCT, 4000 IU 1 year 2nd 2000/800 IU
20,000 IU weeklyLupus T
Tzero flares
Pain reducedLoading then 100,000 IU monthly,
RCT too
RCT 4,000 IUSickle Cell T Less pain RCT, up to 100,000 IU/week Leg ulcer healing T 4X faster RCT, 50,0000 IU/week, small study Traumatic Brain Injury T 2X RCT, 20,0000 IU/day with progesterone Parkinson's Disease T Stabilized RCT, 1200 IU/day Multiple Sclerosis P
T68%
95% were CUREDRCT, 7100 IU prevent pre-MS ==> MS
20,000 to 140,000 IU/dayCongestive Heart Failure T 90 % RCT, 1000 IU infants (also: Adults, not RCT) Middle Ear Infection P 30 % RCT, 1000 IU infants Gingivitis T 88 % RCT, 2000 IU Muscle in seniors T 17 % more muscle RCT, 4000 IU Antibiotic use when >70y T 47 % RCT, 60,000 IU monthly Infants taller Benefit 1 cm tall RCT, 50,000 IU weekly,
for 8 weeks while pregnantGestational Diabetes T Reduced 3X RCT, 2 doses of 50,000 IU After Heart Attack T +6% ejection fraction RCT, 800,000 IU one time Prostate Cancer T Fewer +cores RCT, 4000 IU (2012) Asthma P T Reduced symptoms RCT, 60K IU/month;
RCT 50K IU/week
Need good D at 4 weeks into preg.Depression T Reduced RCT 300,000 IU injection
RCT 1500 IU helped Prozac
RCT 50,000 IU weekly, elderlyLow vitamin D
while breastfedP All infants > 20 mg RCT, 5,000 IU Fibromyalgia T Half of many still has Fibro RCT, 30-48 ng
RCT 50K IU/weekHives, Chronic T Reduced 40% RCT, 4000 IU added Cholesterol T Reduced 4 mg RCT, 400 IU + Ca Weight Loss T lost 5 more lbs RCT, 2000 IU +diet +exercise Gestational Diabetes P 40% RCT * , 5,000 IU Chronic Obstructive
Pulmonary DiseaseT 17X improvement CT, 50,000 IU weekly
RCT 100,000 IU monthlyAsthma T 1/2 Asthma attacks RCT >42 mg of vitamin D Quality of Life (QoL) T Nursing Home QoL CT, 4,000 IU in daily bread Death of Critically Ill
PatientsT 20% increase in survivability RCT 540 K IU loading than 90K monthly Restless Leg Syndrome T Score 26 ==> 10 CT, Vitamin D dose size
not stated in abstractHepatitis-C T Aided normal drugs RCT 2.000 IU Crohn's disease T improved when > 30 ng
2nd study fewer relapsesRCT 2,000 IU
10,000 IU RCTPre-term birth P 2.5X decrease, also: fewer
c-section & better ApgarRCT 2,000 IU India Cluster headaches T CH eliminated in 60% 10,000 IU, Mg, Omega-3, etc Autism T 80% improved CT 300 IU/kg/day for 3 months PreDiabetes T ~20% reduced RCT 60,000 IU/month Weight loss:
Overweight and ObeseT 12 lbs in 6 months RCT 100,000 IU/month Sarcopenia = muscle loss T 27% increase RCT 1,000 IU Growing Pains T 60% decrease ~100,000 IU/month -NOT RCT
2nd study, similar resultsOsteoarthritis pain T 60% decrease 50,000 IU/weekly - NOT RCT ALS T helped 2,000 IU - NOT RCT, given to all Vertigo T 3X reduction if raised > 10ng 600,000 IU load, then maint.
NOT RCT, given to allWarts T 80% eliminated injection NOT RCT
60,000 IU/injectionMetabolic Syndrome P reduced 44% when VitD
increased by 30 ngNOT RCT, given to all Hay fever P reduced 48% RCT 1,000 IU for 30 days Preeclampsia P Recurrance cut in half
3 RCT 3.6 X less likely if > 30 ng50,000 IU every 2 weeks
4,000 IU dailyBlood cell cancer
Multiple MyelomaT Survival 90% vs 50% 10,000 IU/week
NOT RCT, given to allIrritable Bowel Syndrome T Reduced 3,000 IU spray RCT Urinary Tract Infection P 50% reduction RCT 20,000 IU weekly Mite Allergy P 5X reduction RCT 2,000 IU preg, 800 IU child Perinatal depression
(depression near birth)T 50% reduction RCT 2,000 IU for just a few weeks Vaginosis T 10X reduction RCT 2,000 IU Eczema T Reduced 2 RCT 1,600 IU Non-Alcoholic
Fatty Liver DiseaseT Reduced RCT 20,000 IU weekly Knee Osteoartiritis T Pain Reduced RCT 60,000 IU monthly after loading dose Tuberculosis T Faster Recovery RCT single 450,000 IU dose Stroke - Ischemic T Faster Recovery RCT single 600,000 IU injection
RCT single 300,000 IU injectionSepsis T Reduce ICU and Hospital
length of stay by 7 days eachRCT 400,000 IU Trauma deaths T 50% fewer deaths Vitamin D & Glutamine
NOT RCT, given to allHemodialysis patients T helped 50,000 IU weekly NOT RCT, given to all Fatty liver - child T 2 X reduction RCT Vitamin D & DHA Fatigue T Reduced 100,000 IU single dose
NOT RCT, given to allSleep Disorders T Nicely treated RCT 50.000 IU bi-weekly Pneumonia
(Ventilator-associated)T RCT Death rate cut in half 300,000 IU injection Infertile males T birth rate doubled RCT 300,000 IU + maint Waist size T Waist size reduced 3 cm 100,000 IU loading + maint for 6 months
for those with Metabolic Syndrome
NOT RCT, given to allAttention Deficient
Hyperactivity DisorderT Reduced
ReducedRCT 3,000 IU for 12 weeks
RCT 50,000 IU weeklyAlcoholic liver cirrhosis T improved survival 1,000 IU of vitamin D NOT RCT Diabetic nephropathy T Reduced HOMA-IR, FRS RCT 50,000 IU weekly Ulcerative Colitis T Reduced 60% RCT 50,000 IU nano daily for a week Obese weight loss T Lost 3X more pounds $10 of Vitamin D added to
calorie restriction & walkingEndometriosis T Nicely treated RCT 50.000 IU bi-weekly Diabetic Wounds T 4X more likely to heal RCT 6,400 daily Alzheimer's T Often reverse Each person gets a different amount of
Vit D, Omega-3, B12, Iron, etcAutoimmune P Decrease 30% RCT Vit D + Omega-3 Smoking T reduce problems RCT 50,000 bi-weekly Tonsillitis T Virtually eliminated RCT 50,000 weekly Hypertension once again proven to not be reduced by 1,000 IU of vitamin D – Aug 2013Printer Friendly Follow this page for updates10517 visitors, last modified 27 Sep, 2013, This page is in the following categories (# of items in each category) - Proof that Vitamin D Works look at the first proof that vitamin D works, notice that the first proof listed = Hypertension for 2400 IU, not 1,000 IU