Cholecalciferol administration blunts the systemic renin–angiotensin system in essential hypertensives with hypovitaminosis D
Journal of Renin-Angiotensin-Aldosterone System January 2, 2013 1470320312471149
Davide Carrara
Matteo Bernini
Alessandra Bacca
Ilaria Rugani
Emiliano Duranti
Agostino Virdis
Lorenzo Ghiadoni
Stefano Taddei
Giampaolo Bernini
Department of Internal Medicine, University of Pisa, Italy
Davide Carrara, Department of Internal Medicine, University of Pisa, Via Roma 67, Pisa 56100, Italy. Email: davide.carrara@hotmail.it
Introduction: Vitamin D plasma levels are negatively associated with blood pressure and cardiovascular mortality, and vitamin D supplementation reduces cardiovascular events. Renin–angiotensin system (RAS) suppression may be one of the mechanisms involved. However, there are no interventional prospective studies demonstrating a reduction in circulating RAS components after vitamin D treatment.
Methods: Fifteen consecutive drug-free patients with essential hypertension and hypovitaminosis D underwent therapy with an oral dose of 25000 I.U. of cholecalciferol once a week for two months, while maintaining a constant-salt diet. In basal conditions and at the end of the study, RAS activity (plasma angiotensinogen, renin, PRA, angiotensin II, aldosterone and urinary angiotensinogen) was investigated, in addition to blood pressure and plasma vitamin D levels (25(OH)D).
Results: After cholecalciferol administration, all patients exhibited normalized plasma 25(OH)D values. At the end of the study, a reduction (p < 0.05) in plasma renin and aldosterone, and a decrement, although not significant, of PRA and angiotensin II, was observed. No difference was found in plasma and urinary angiotensinogen or blood pressure values.
Conclusions: Our data indicate that in essential hypertensives with hypovitaminosis D, pharmacological correction of vitamin D levels can blunt systemic RAS activity.
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renin–angiotensin–aldosterone system (RAAS) is a hormone system that regulates blood pressure and water (fluid) balance.
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