Skip to main content Accessibility help
×
Home

Circulating 25-hydroxyvitamin D levels in relation to blood pressure parameters and hypertension in the Shanghai Women's and Men's Health Studies

  • Tsogzolmaa Dorjgochoo (a1), Xiao Ou Shu (a1), Yong-Bing Xiang (a2), Gong Yang (a1), Qiuyin Cai (a1), Honglan Li (a2), Bu-Tian Ji (a3), Hui Cai (a1), Yu-Tang Gao (a2) and Wei Zheng (a1)...

Abstract

Little is known about the association of circulating 25-hydroxyvitamin D (25(OH)D) and blood pressure (BP) parameters, including systolic and diastolic BP, pulse pressure (PP), mean arterial pressure (MAP) and hypertension in non-Western populations that have not yet been exposed to foods fortified with vitamins and seldom use vitamin D supplements. A cross-sectional analysis of plasma 25(OH)D levels in association with BP measures was performed for 1460 participants (1055 women and 405 men, aged 40–74 years) of two large cohort studies in Shanghai. Multivariable linear and logistic regressions were conducted. Overall, the prevalence of vitamin D deficiency was 55·8 % using National Health and Nutrition Examination Survey, USA criteria and 29·9 % using WHO criteria. The median plasma 25(OH)D level in the population was 38·0 nmol/l for men and 33·6 nmol/l for women (P < 0·01) among participants who were not on antihypertensive drugs. Among men, BP parameters (systolic BP, diastolic BP and MAP) were significantly and inversely associated with higher quintiles of 25(OH)D compared with the lowest quintile (Ptrend < 0·05 for all). Vitamin D non-deficient status (WHO criteria) was inversely associated with hypertension (ORadjusted = 0·29; 95 % CI 0·10, 0·82). An inverse association was also found between hypertension and the highest quintile of 25(OH)D (ORadjusted = 0·16; 95 % CI 0·04, 0·65 for ≥ 50·6 nmol/l; Ptrend = 0·02). Among women, no significant associations were found for BP parameters and hypertension. The present study shows that vitamin D deficiency is common among adults in urban China. Circulating 25(OH)D levels were inversely related to the levels of individual BP parameters and hypertension among middle-aged and elderly men but not among women. More research is needed to investigate the potential sex differential associations.

Copyright

Corresponding author

*Corresponding author: Dr X. O. Shu, fax +1 615 936 8291, email xiao-ou.shu@vanderbilt.edu

References

Hide All
1Kinuta, K, Tanaka, H, Moriwake, T, et al. (2000) Vitamin D is an important factor in estrogen biosynthesis of both female and male gonads. Endocrinology 141, 13171324.
2Li, YC, Qiao, G, Uskokovic, M, et al. (2004) Vitamin D: a negative endocrine regulator of the renin-angiotensin system and blood pressure. J Steroid Biochem Mol Biol 89–90, 387392.
3Holick, MF (2005) Vitamin D: important for prevention of osteoporosis, cardiovascular heart disease, type 1 diabetes, autoimmune diseases, and some cancers. South Med J 98, 10241027.
4Martini, LA & Wood, RJ (2008) Vitamin D and blood pressure connection: update on epidemiologic, clinical, and mechanistic evidence. Nutr Rev 66, 291297.
5O'Donnell, S, Cranney, A, Horsley, T, et al. (2008) Efficacy of food fortification on serum 25-hydroxyvitamin D concentrations: systematic review. Am J Clin Nutr 88, 15281534.
6Holden, JM & Lemar, LE (2008) Assessing vitamin D contents in foods and supplements: challenges and needs. Am J Clin Nutr 88, 551S553S.
7Holick, MF (2009) Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol 19, 7378.
8Muray, S, Parisi, E, Cardus, A, et al. (2003) Influence of vitamin D receptor gene polymorphisms and 25-hydroxyvitamin D on blood pressure in apparently healthy subjects. J Hypertens 21, 20692075.
9Forman, JP, Giovannucci, E, Holmes, MD, et al. (2007) Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension 49, 10631069.
10Scragg, R, Sowers, M & Bell, C (2007) Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens 20, 713719.
11Scragg, RK, Camargo, CA Jr & Simpson, RU (2010) Relation of serum 25-hydroxyvitamin D to heart rate and cardiac work (from the National Health and Nutrition Examination Surveys). Am J Cardiol 105, 122128.
12Pittas, AG, Chung, M, Trikalinos, T, et al. (2010) Systematic review: vitamin D and cardiometabolic outcomes. Ann Intern Med 152, 307314.
13Snijder, MB, Lips, P, Seidell, JC, et al. (2007) Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. J Intern Med 261, 558565.
14Nagpal, J, Pande, JN & Bhartia, A (2009) A double-blind, randomized, placebo-controlled trial of the short-term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle-aged, centrally obese men. Diabet Med 26, 1927.
15Scragg, R, Khaw, KT & Murphy, S (1995) Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr 49, 640646.
16Argiles, A, Lorho, R, Servel, MF, et al. (2002) Blood pressure is correlated with vitamin D(3) serum levels in dialysis patients. Blood Purif 20, 370375.
17Dorjgochoo, T, Shu, XO, Zhang, X, et al. (2009) Relation of blood pressure components and categories and all-cause, stroke and coronary heart disease mortality in urban Chinese women: a population-based prospective study. J Hypertens 27, 468475.
18Fang, XH, Longstreth, WT Jr, Li, SC, et al. (2001) Longitudinal study of blood pressure and stroke in over 37,000 People in China. Cerebrovasc Dis 11, 225229.
19Jurj, AL, Wen, W, Xiang, YB, et al. (2007) Reproducibility and validity of the Shanghai Men's Health Study physical activity questionnaire. Am J Epidemiol 165, 11241133.
20Zheng, W, Chow, WH, Yang, G, et al. (2005) The Shanghai Women's Health Study: rationale, study design, and baseline characteristics. Am J Epidemiol 162, 11231131.
21Gallicchio, L, Helzlsouer, KJ, Chow, WH, et al. (2010) Circulating 25-hydroxyvitamin D and the risk of rarer cancers: design and methods of the cohort consortium vitamin D pooling project of rarer cancers. Am J Epidemiol 172, 1020.
22Chobanian, AV, Bakris, GL, Black, HR, et al. (2003) Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 42, 12061252.
23Shu, XO, Yang, G, Jin, F, et al. (2004) Validity and reproducibility of the food frequency questionnaire used in the Shanghai Women's Health Study. Eur J Clin Nutr 58, 1723.
24Yang, G, Wang, G & Pan, X (2002) China Food Composition. Beijing: Peking University Medical Press.
25Hollis, BW (2005) Circulating 25-hydroxyvitamin D levels indicative of vitamin D sufficiency: implications for establishing a new effective dietary intake recommendation for vitamin D. J Nutr 135, 317322.
26World Health Organization and Food and Agricultural Organization of the United Nations (2004) Vitamin and Mineral Requirements in Human Nutrition. Geneva: WHO.
27Lu, L, Yu, Z, Pan, A, et al. (2009) Plasma 25-hydroxyvitamin D concentration and metabolic syndrome among middle-aged and elderly Chinese individuals. Diabetes Care 32, 12781283.
28Tomaschitz, A, Pilz, S, Ritz, E, et al. (2010) Independent association between 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D and the renin-angiotensin system: the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. Clin Chim Acta 411, 13541360.
29Wang, TJ, Pencina, MJ, Booth, SL, et al. (2008) Vitamin D deficiency and risk of cardiovascular disease. Circulation 117, 503511.
30Young, EW, McCarron, DA & Morris, CD (1990) Calcium regulating hormones in essential hypertension. Importance of gender. Am J Hypertens 3, 161S166S.
31Gunnarsson, O, Indridason, OS, Franzson, L, et al. (2009) Factors associated with elevated or blunted PTH response in vitamin D insufficient adults. J Intern Med 265, 488495.
32Schmitz, KJ, Skinner, HG, Bautista, LE, et al. (2009) Association of 25-hydroxyvitamin D with blood pressure in predominantly 25-hydroxyvitamin D deficient Hispanic and African Americans. Am J Hypertens 22, 867870.
33Gannage-Yared, MH, Chedid, R, Khalife, S, et al. (2009) Vitamin D in relation to metabolic risk factors, insulin sensitivity and adiponectin in a young Middle-Eastern population. Eur J Endocrinol 160, 965971.
34Gallagher, JC & Sai, AJ (2010) Vitamin D insufficiency, deficiency, and bone health. J Clin Endocrinol Metab 95, 26302633.
35Muray, S, Marco, MP, Craver, L, et al. (2006) Influence of mineral metabolism parameters on pulse pressure in healthy subjects. Clin Nephrol 66, 411417.
36Reichel, H, Liebethal, R, Hense, HW, et al. (1992) Disturbed calcium metabolism in subjects with elevated diastolic blood pressure. Clin Investig 70, 748751.
37Chan, R, Chan, D, Woo, J, et al. (2011) Serum 25-hydroxyvitamin D and parathyroid hormone levels in relation to blood pressure in a cross-sectional study in older Chinese men. J Hum Hypertens (epublication ahead of print version 20 January 2011).
38Lind, L, Wengle, B, Wide, L, et al. (1988) Hypertension in primary hyperparathyroidism–reduction of blood pressure by long-term treatment with vitamin D (alphacalcidol). A double-blind, placebo-controlled study. Am J Hypertens 1, 397402.
39Lind, L, Wengle, B, Wide, L, et al. (1989) Reduction of blood pressure during long-term treatment with active vitamin D (alphacalcidol) is dependent on plasma renin activity and calcium status. A double-blind, placebo-controlled study. Am J Hypertens 2, 2025.
40Pfeifer, M, Begerow, B, Minne, HW, et al. (2001) Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab 86, 16331637.
41Martins, D, Wolf, M, Pan, D, et al. (2007) Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 167, 11591165.
42Jorde, R, Figenschau, Y, Emaus, N, et al. (2010) Serum 25-hydroxyvitamin D levels are strongly related to systolic blood pressure but do not predict future hypertension. Hypertension 55, 792798.
43Rueda, S, Fernandez-Fernandez, C, Romero, F, et al. (2008) Vitamin D, PTH, and the metabolic syndrome in severely obese subjects. Obes Surg 18, 151154.
44Parker, J, Hashmi, O, Dutton, D, et al. (2009) Levels of vitamin D and cardiometabolic disorders: systematic review and meta-analysis. Maturitas 65, 225236.
45Krause, R, Buhring, M, Hopfenmuller, W, et al. (1998) Ultraviolet B and blood pressure. Lancet 352, 709710.
46Weber, KT, Rosenberg, EW & Sayre, RM (2004) Suberythemal ultraviolet exposure and reduction in blood pressure. Am J Med 117, 281282.
47Oplander, C, Volkmar, CM, Paunel-Gorgulu, A, et al. (2009) Whole body UVA irradiation lowers systemic blood pressure by release of nitric oxide from intracutaneous photolabile nitric oxide derivates. Circ Res 105, 10311040.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed