Should the Concentration of Vitamin D be Measured in All Patients with Hypertension?

J Clin Hypertens (Greenwich). 2010 March; 12(3): 149–152. doi: 10.1111/j.1751-7176.2009.00246.x.
Angela Boldo, M.D., Patrick Campbell, MD, Pooja Luthra, M.D., and William B. White, M.D. (wwhite@nso1.uchc.edu ) Division of Hypertension and Clinical Pharmacology, Pat and Jim Calhoun Cardiology Center (AB, PC, and WBW) and the Division of Endocrinology and Metabolism (PL), University of Connecticut School of Medicine, Farmington, Connecticut

No abstract

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Hypertension high if vitamin D low

Clipped from the PDF

Vitamin D and Hypertension

Epidemiologic association between Vitamin D deficiency and hypertension— Data from the INTERSALT study suggest a rise in BP is proportional to distance from the equator 12 while seasonal variations in BP have also been reported in temperate climates 13.

Population studies have shown an inverse relationship between vitamin D levels and hypertension, with increasing incidence of hypertension as Vitamin D levels decrease 6,14. The largest database is from Forman and colleagues (6) using 117,730 subjects from the Health Professional follow-up study and the Nurse's Health Studies in which there was a median follow-up period of 4 years for the development of incident hypertension. When comparing those individuals whose 25-0H D levels were < 15 ng/ml versus those > 30 ng/ ml, the relative risk of developing hypertension was 3.18, with a marked gender difference (6.13 in men and 2.67 in women). Hence, a significant inverse relationship exists between vitamin D and development of hypertension.

Conclusions

With mounting evidence indicating the direct effect of vitamin D on the vascular smooth muscle cell, endothelial function and the renin-angiotensin-aldosterone system, it is clear that randomized trials of vitamin D replacement and renin and angiotensin inhibition in patients with hypertension and vitamin D deficiency are warranted. Preliminary research has shown an inverse relationship between BP and vitamin D levels, and supplementation appears promising. To that end, we have just initiated a randomized clinical trial evaluating the effects of vitamin D and/or a renin inhibitor on ambulatory and clinic BP in vitamin D deficient patients with hypertension (clinical trials.gov identifier NCT00974922).

The high prevalence of vitamin D deficiency and insufficiency, particularly in northern latitudes and during the winter months, supports determining 25-hydroxyvitamin D levels in patients with hypertension and supplementation provided to those whose levels are < 30 ng/ ml. It is noteworthy that recommended 25-OH D levels of > 30 ng/ml (75 nmol/L) are unlikely to be achieved with the previous recommendation of 200 IU for younger people and
600 IU of vitamin D for older adults 3.

Doses of vitamin D3 from 1000 to 2000 IU daily are often required 4,25. For every 100 IU of vitamin D ingested, the levels in patients with vitamin D deficiency should increase by 1 ng/ml 4.

Therefore, to bring most of the adult population to levels of > 30 ng/ml, vitamin D supplementation of 1000 IU would be required in most, but even doses as high as 4,000 I.U. are safe for short-term ‘loading’, and would bring about 90% of the population to levels above 30 ng/ml within a few weeks.

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See also VitaminDWiki

• Overview Cardiovascular and vitamin D
• Meta-analysis found hypertension reduced with vitamin D – Dec 2010
• Hypertension more likely with less vitamin D - Dec 2010 authors work for Kaiser Permanente
• Vitamin D reduced blood pressure in random controlled trials – Nov 2010
• Systolic hypertension 4X more likely if low on vitamin D 14 years before – Nov 2010
• Hypertension and vitamin D many papers
• Does vitamin D deficiency cause hypertension? 2010 with PDF
• Systolic hypertension 4X more likely if low on vitamin D 14 years before – Nov 2010
• 11 ng less vitamin D increases hypertension probability by 14 percent – Nov 2010
• All items in category Hypertension and vitamin D
• Less than 15ng were 3X more likely to be hypertensive - 2010.pdf
• 25 percent of racial disparity in Blood Pressure is due to Vitamin D – April 2011
• Link between vitamin D and hypertension not yet completely understood – April 2011
• Arterial stiffness reduced with vitamin D intervention – June 2011

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Noticed that Dr. White is also involved in a clinical trial

Vitamin D Deficiency in Patients With Hypertension - 3000 IU of vitamin D daily