The Relationship of Plasma Vitamin D Status with Markers of Metabolic Syndrome and Ambulatory Blood Pressure Monitoring Parameters in Patients with Primary Hypertension

Document Type : Original Article (s)

Authors

1 Department of Nutrition, Student Research Committee, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

2 Assistant Professor, Department of Cardiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

3 Associate Professor, Food and Beverages Safety Research Center, Department of Nutrition AND School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

Abstract

Background: Hypertension is one of the leading causes of mortality in the world. The aim of this study was to evaluate the relationship of plasma 25-hydroxyvitamin D levels with markers of metabolic syndrome and ambulatory blood pressure monitoring.Methods: This was a cross-sectional study on 171 adults (79 men) with primary hypertension and mean age of 50.70 ± 10.88 years, who did not take vitamin D supplement for the past 6 months. Subjects were divided into two groups as deficient (30 ng/ml ≥) and normal levels of vitamin D (30 ng/ml <) and compared for metabolic syndrome indices and 24-hour blood pressure monitoring parameters. Hypertension was defined based on Eighth Joint National Committee (JNC8) scale, and measured by an ambulatory blood pressure monitoring device. Ambulatory blood pressure monitoring parameters were defined as 24-hour blood pressure (mean during 24 hours), daytime (6-23 hours), and nighttime (23-6 hours) measurements.Findings: The mean vitamin D level was 30.43 ± 4.70 ng/ml, and 65.5% of patients had vitamin D deficiency. Serum vitamin D levels had an inverse and significant relationship with office systolic blood pressure (P = 0.001), and 24-hour, daytime, and nighttime systolic blood pressures (P < 0.001). Vitamin D deficiency was significantly associated with higher levels of triglycerides (P < 0.001) and cholesterol (P = 0.016).Conclusion: Vitamin D deficiency was associated with higher systolic blood pressure, nighttime diastolic blood pressure, and impaired serum lipid profiles.

Keywords


  1. Poulter NR, Prabhakaran D, Caulfield M. Hypertension. Lancet 2015; 386(9995): 801-12.
  2. Oparil S, Acelajado MC, Bakris GL, Berlowitz DR, Cifkova R, Dominiczak AF, et al. Hypertension. Nat Rev Dis Primers 2018; 4: 18014.
  3. Hernandez-Vila E. A review of the JNC 8 Blood Pressure Guideline. Tex Heart Inst J 2015; 42(3): 226-8.
  4. Mirzaei M, Moayedallaie S, Jabbari L, Mohammadi M. Prevalence of Hypertension in Iran 1980-2012: A Systematic Review. J Tehran Heart Cent 2016; 11(4): 159-67.
  5. National Clinical Guideline Centre (UK). Hypertension: The Clinical Management of Primary Hypertension in Adults: Update of Clinical Guidelines 18 and 34. London, UK: Royal College of Physicians (UK); 2011.
  6. Redon J. The importance of 24-hour ambulatory blood pressure monitoring in patients at risk of cardiovascular events. High Blood Press Cardiovasc Prev 2013; 20(1): 13-8.
  7. Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc 2013; 88(7): 720-55.
  8. Garg U. 25-Hydroxyvitamin D Testing: Immunoassays versus tandem mass spectrometry. Clin Lab Med 2018; 38(3): 439-53.
  9. Holick MF. Vitamin D deficiency. N Engl J Med 2007; 357(3): 266-81.
  10. Tabrizi R, Moosazadeh M, Akbari M, Dabbaghmanesh MH, Mohamadkhani M, Asemi Z, et al. High Prevalence of Vitamin D Deficiency among Iranian Population: A Systematic Review and Meta-Analysis. Iran J Med Sci 2018; 43(2): 125-39.
  11. Shu L, Huang K. Effect of vitamin D supplementation on blood pressure parameters in patients with vitamin D deficiency: a systematic review and meta-analysis. J Am Soc Hypertens 2018; 12(7): 488-96.
  12. 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(5): 745-54.
  13. Wu SH, Ho SC, Zhong L. Effects of vitamin D supplementation on blood pressure. South Med J 2010; 103(8): 729-37.
  14. de la Sierra A. Ambulatory blood pressure monitoring is a useful tool for all patients. Hipertens Riesgo Vasc 2017; 34(1): 45-9. [In Spanish].
  15. Alshahrani F, Aljohani N. Vitamin D: deficiency, sufficiency and toxicity. Nutrients 2013; 5(9): 3605-16.
  16. Prasad P, Kochhar A. Interplay of vitamin D and metabolic syndrome: A review. Diabetes Metab Syndr 2016; 10(2): 105-12.
  17. Fu J, Han L, Zhao Y, Li G, Zhu Y, Li Y, et al. Vitamin D levels are associated with metabolic syndrome in adolescents and young adults: The BCAMS study. Clin Nutr 2019; 38(5): 2161-7.
  18. Schmitt EB, Nahas-Neto J, Bueloni-Dias F, Poloni PF, Orsatti CL, Petri Nahas EA. Vitamin D deficiency is associated with metabolic syndrome in postmenopausal women. Maturitas 2018; 107: 97-102.
  19. Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens 2007; 20(7): 713-9.
  20. Jorde R, Figenschau Y, Emaus N, Hutchinson M, Grimnes G. Serum 25-hydroxyvitamin D levels are strongly related to systolic blood pressure but do not predict future hypertension. Hypertension 2010; 55(3): 792-8.
  21. Kar A, Datta S. A study of serum Vitamin D level and its association with hypertension. J Family Med Prim Care 2018; 7(3): 546-50.
  22. Caro Y, Negron V, Palacios C. Association between vitamin D levels and blood pressure in a group of Puerto Ricans. P R Health Sci J 2012; 31(3): 123-9.