More studies needed before recommending vitamin D for hypertensive patients

Experimental animal and epidemiological studies have clearly shown an association between low levels of vitamin D and hypertension. However, there is not enough evidence to support recommending vitamin D to hypertensive patients to reduce blood pressure, according to a recently published review.


“There are a few reports demonstrating the beneficial effects of vitamin D supplementation in reducing blood pressure in patients with hypertension; however, these studies are not sufficient to draw any conclusions, and many more studies with different age groups of populations from different regions are still required.”
-Harbans Lal, PhD, professor of Biochemistry in the Departments of Medicine and Biochemistry at the Maharaja Agrasen Medical College, Agroha (Hisar), Haryana


In India, the estimated prevalence of hypertension in individuals aged 25 years and older is[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] 30.3% for men and 27% for women. Hypertension is a major risk factor for stroke, myocardial infarction, heart failure, chronic kidney disease, peripheral vascular disease, cognitive decline, and premature death.

Key Point: Evidence from current epidemiological and interventional studies do not support the use of vitamin D therapy to reduce blood pressure in hypertensive patients. More research is needed to explain how vitamin D appears to reduce cardiovascular mortality in these patients and in the general population.

Dr Harbans Lal, PhD, professor of Biochemistry in the Departments of Medicine and Biochemistry at the Maharaja Agrasen Medical College, Agroha (Hisar), Haryana, a prominent researcher investigating the role of vitamin D in hypertension, emphasized that the prevalence of hypertension is very high in the Indian population. At the same time, there are a few studies that show vitamin D status in the Indian population is low, in spite of plenty of sunshine. “There are also a few reports demonstrating the beneficial effects of vitamin D supplementation in reducing blood pressure in patients with hypertension; however, these studies are not sufficient to draw any conclusions, and many more studies with different age groups of populations from different regions are still required,” Lal said.

Research indicating that the vitamin D receptor influences blood pressure through effects on the renin angiotensin system, the heart, the kidney, and the blood vessels had led to the hope that vitamin D therapy could be a successful treatment for hypertensive patients. Furthermore, cross-sectional studies clearly show that low levels of vitamin D are associated with increased blood pressure. However, evidence from longitudinal studies does not substantiate this association, and randomized interventional trials do not find any effect of vitamin D on blood pressure, found the recently published review conducted by researchers from Switzerland.

Taken together, these data indicate that there is not enough evidence to recommend giving vitamin D to reduce blood pressure in hypertensive patients. However, serum concentrations of vitamin D are inversely associated with all-cause and cardiovascular mortality among adults with hypertension, suggesting the need for future research to explain how vitamin D may reduce cardiovascular mortality in these patients and in the general population.

Of note, another recent study (http://mdcurrent.in/primary-care/excessive-vitamin-d-correlated-with-higher-blood-levels-of-the-inflammatory-marker-c-reactive-protein/) found that the association between serum vitamin D level and the serum level of the inflammatory marker C-reactive protein (CRP) is apparent only at specific levels of vitamin D. At levels of serum vitamin D above the median, serum CRP actually increases, the study found. CRP, which measures general levels of inflammation in the body, can be a marker of chronic disease, especially cardiovascular disease, or infections.

Sources:
Wuerzner G, Burnier M, Waeber B. Should hypertensive patients take Vitamin D? Curr Hypertens Rep. 2012;14(4):318-323.

Goel RK, Lal H. Role of vitamin D supplementation in hypertension. 2011;26(1):88–90. Indian J Clin Biochem. 2011;26(1):88-90.

Access the original journal information here:
http://www.ncbi.nlm.nih.gov/pubmed/22648128
Journal publishers are independent from mdCurrent-India and may require a subscription or charge a fee to download the full article.

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This entry was posted in Hypertension, Non-Communicable Disease, Nutrition, Primary Care and tagged , , , , , , , . Volume: .

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