Hypertension and vitamin D

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  •       (More Hypertension info below)

Hypertension associated with genes which reduce vitamin D – meta-analysis June 2014

Hypertension associated with genes which reduce vitamin D – meta-analysis June 2014 in VitaminDWiki
Good genes which increase vitamin D by 10% result in decreased risk of hypertension by 8%

What Do We Know and Do Not Know About Vitamin D and hypertension – Sept 2014

What Do We Know and Do Not Know About Vitamin D and hypertension – Sept 2014
Genes play a small role

Hypertension Review by Vitamin D Council April 2014

Hypertension Review at Vitamin D Council April 2014

  • Worldwide, about 4 out of 10 people have hypertension.
  • In the United States, 1 out of every 3 adults has hypertension
  • Recent research: For each 10 ng/ml more vitamin D, 12% lower risk of developing hypertension.
  • Key points from the research
  1. Research has shown that people with higher vitamin D levels are more likely to have lower blood pressure and are less likely to develop hypertension.
  2. Studies have shown that taking a vitamin D supplement can reduce blood pressure in people with hypertension.
  3. Some research has shown that taking a vitamin D supplement helps regulate the blood pressure system in the body.
  4. However, not all trials show reduced blood pressure after taking vitamin D.
    This means that we can’t say for sure if vitamin D is a main factor in preventing hypertension or in lowering blood pressure.

Hypertension reduction needs more than 4,000 IU of vitamin D for 6 months – RCT Oct 2014

Hypertension reduction sometimes needs more than 4,000 IU of vitamin D for 6 months – RCT Oct 2014 in VitaminDWiki

Omega-3, Magnesium and Coenzyme Q10 may each be better than Vitamin D

See also at VitaminDWiki

Far fewer heart problems for those with hypertension if they have > 15 ng of vitamin D

see wikipage:http://www.vitamindwiki.com/tiki-index.php?page_id=1742

Linus Pauling Institute on Vitamin D and Blood Pressure: Dec 2011

Linus Pauling Institute on Vitamin D and Blood Pressure: Dec 2011

Blood Pressure Regulation

The renin-angiotensin system plays an important role in the regulation of blood pressure (13). Renin is an enzyme that catalyzes the cleavage (splitting) of a small peptide (Angiotensin I) from a larger protein (angiotensinogen) produced in the liver. Angiotensin converting enzyme (ACE) catalyzes the cleavage of angiotensin I to form angiotensin II, a peptide that can increase blood pressure by inducing the constriction of small arteries and by increasing sodium and water retention. The rate of angiotensin II synthesis is dependent on renin (14). Research in mice lacking the gene encoding the VDR indicates that 1,25-dihydroxyvitamin D decreases the expression of the gene encoding renin through its interaction with the VDR (15). Since inappropriate activation of the renin-angiotensin system is thought to play a role in some forms of human hypertension, adequate vitamin D levels may be important for decreasing the risk of high blood pressure.

2360 IU average reduced Systolic blood pressure in Clinical Trial - 2011

Role of vitamin d supplementation in hypertension.
by: R. K. Goel, Harbans Lal
Indian journal of clinical biochemistry : IJCB, Vol. 26, No. 1. (29 January 2011), pp. 88-90. doi:10.1007/s12291-010-0092-0 Key: citeulike:8626469

Role of Vitamin D supplementation was studied in patients with hypertension.
One hundred hypertensive patients (group I) were given conventional antihypertensive drugs
while another 100 patients (group II), in addition, were supplemented with Vitamin D(3) (33,000 IU, after every 2 weeks, for 3 months).

Besides diastolic and systolic blood pressure, serum calcium, phosphorous, alkaline phosphatase, albumin, albumin-corrected calcium, and 24 h urinary creatinine levels were estimated in both the groups before the start of treatment and after 3 months.

Vitamin D supplementation showed a more significant decrease in systolic blood pressure.
This group also showed a significant increase in serum calcium as well as albumin-corrected calcium with a decrease in phosphorous.
Results of the study confirm that Vitamin D supplementation has a role in reducing blood pressure in hypertensive patients and that it should be supplemented with the antihypertensive drugs. More extensive studies with a larger group, to draw a definite conclusion, are in progress.

Clinical Trials: Hypertension and Vitamin D

Search hypertension, intervention, vitamin D 24 studies as of Jan 2015
Reduce Cardiac Damage 50,000 IU vitamin D every 2 weeks
Patients With Hypertension 3,000 IU daily for 6 weeks

Prehypertension ==> hypertension quickly in blacks - Feb 2012

Prehypertension Feb 2012
Letter to the Editor: Prehypertension: To Treat or Not To Treat Should No Longer Be the Question

We read with great interest the article by Selassie et al1 that progression from prehypertension to full-blown hypertension occurs more rapidly in blacks, with 50% transitioning to hypertension within 1.7 years compared with 2.7 years in whites. Although the authors highlight the importance of controlling prehypertension, we feel that the authors missed an opportunity to stress the feasibility of using antihypertensive drugs to control prehypertension. As we argued previously,2 the recommendation by the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure to treat prehypertension only with lifestyle changes3 is unlikely to work. Our view that prehypertension should be treated pharmacologically is supported by a recent meta-analysis of 16 trials involving 70664 patients.4 This analysis found that prehypertensive patients randomized to the active treatment arm had a 22% reduction in the risk of stroke as compared with the placebo group. In addition, treatment of prehypertension with an angiotensin receptor blocker reduced the risk of incident hypertension.5 Thus, the debate of whether to treat prehypertension should end. Treating prehypertension is medically sound and economically viable,2 and benefits of treatment are now apparent.

Shawn G. Kwatra, Wake Forest University School of Medicine, Winston-Salem, NC
Amanda E. Kiely, Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD
Madan M. Kwatra, Department of Anesthesiology, Duke University Medical Center, Durham, NC

(Note from VitaminDWiki: Vitamin D reduces both hypertension and prehypertension)

Blood pressures not dropping at night associated with very low level of vitamin D – May 2012

Relationship between Vitamin D Deficiency and Nondipper Hypertension
Clinical and Experimental Hypertension May 17, 2012. (doi:10.3109/10641963.2012.689045)
Mehmet Demir, Tufan Günay, Gökhan Özmen, Mehmet Melek
Cardiology Department, Bursa Yüksek ?htisas Education and Research Hospital, Bursa, Turkey
Address correspondence to Dr. Mehmet Demir, MD, Cardiology Department, Bursa Yüksek ?htisas Education and Research Hospital, Yasemin Park sit 4E D11, Osmangazi, 16100 Bursa, Turkey. E-mail: drmehmetmd at gmail.com

Nondipper hypertension is associated with increased cardiovascular morbidity and mortality. Vitamin D deficiency is associated with cardiovascular diseases such as coronary artery disease, heart failure, and hypertension. Vitamin D deficiency activates the renin–angiotensin–aldosterone system, which affects the cardiovascular system. For this reason, a relationship between vitamin D deficiency and nondipper hypertension could be suggested. In this study, we compared 25-OH vitamin D levels between dipper and nondipper hypertensive patients. The study included 80 hypertensive patients and they were divided into two groups: 50 dipper patients (29 male, mean age 51.5 ± 8 years) and 30 nondipper patients (17 male, mean age 50.6 ± 5.4 years). All the patients were subjected to transthoracic echocardiography and ambulatory 24-hour blood pressure monitoring. In addition to routine tests, 25-OH vitamin D and parathormone (PTH) levels were analyzed. All the patients received antihypertensive drug therapy for at least 3 months prior to the evaluations. 25-OH vitamin D and PTH levels were compared between the two groups. No statistically significant difference was found between the two groups in terms of basic characteristics.

The average PTH level of hypertensive dipper patients was lower than that of nondipper patients (65.3 ± 14.2 vs. 96.9 ± 30.8 pg/mL, P < .001).

The average 25-OH vitamin D level of hypertensive dipper patients was higher than that of nondipper patients (21.9 ± 7.4 vs. 12.8 ± 5.9 ng/mL, P = .001).

The left ventricular mass and left ventricular mass index were lower in the dipper patients than in the nondipper patients (186.5 ± 62.1 vs. 246.3 ± 85.3 g, P = .022; and 111.6 ± 21.2 vs.147 ± 25.7 g/m2, P < .001, respectively).

Other conventional echocardiographic parameters were similar between the two groups. Daytime systolic and diastolic blood pressure measurements were similar between dippers and nondippers, but there was a significant difference between the two groups with regard to nighttime measurements (nighttime systolic 118.5 ± 5.8 vs.130.2 ± 9.6 mm Hg, P < .001; and nighttime diastolic 69.3 ± 4.8 vs.78.1 ± 7.2 mm Hg, P < .001, respectively).

Our results suggest that vitamin D deficiency has a positive correlation with blood pressure and vitamin D deficiency could be related to nondipper hypertension. The measurement of vitamin D may be used to indicate increased risk of hypertension-related adverse cardiovascular events.
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Hypertension drop at night: 22 nanograms
Hypertension NOT drop at night: 13 nanograms

Wikipedia on Hypertenion dipping at night - May 2012
Ambulatory blood pressure monitoring allows blood pressure to be intermittently monitored during sleep, and is useful to determine whether the patient is a dipper or non-dipper--that is to say whether or not blood pressure falls at night compared to daytime values. A night time fall is normal. It correlates with relationship depth but other factors such as sleep quality, age, hypertensive status, marital status, and social network support.[2] Absence of a night time dip is associated with poorer health outcomes, including increased mortality in one recent study.[3] In addition, nocturnal hypertension is associated with end organ damage[4] and is a much better indicator than the daytime blood pressure reading.

Hypertension reduced 6.8 mmHg with 3,000 IU of vitamin D daily – RCT May 2012

22nd European Meeting on Hypertension and Cardiovascular Protection. April 2012, Oral 7A.02
T. Larsen1, F. Mose1, E. Pedersen 1, O. Aagaard 2.
I Department of Medical Research, Holstebro Hospital, Holstebro, Denmark,
2 Department of Medical Biochemistry, Holstebro Hospital, Holstebro, Denmark

Objective: In the northern hemisphere vitamin D deficiency is highly prevalent during winter months, and observational studies have associated hypertension with poor vitamin D status. We tested the hypothesis that vitamin D supplementation in the winter lowers blood pressure (BP) in patients with hypertension.

Design: Randomized, placebo-controlled, double-blind study.

Method: 130 patients with hypertension were randomized to a daily oral dose of 75 ug cholecalciferol or placebo for 20 weeks. The study population consisted of Caucasians residing in Denmark at the 56th northern latitude. Baseline examinations took place from October to November where cutaneous vitamin D synthesis is absent. Primary endpoints were 24-h ambulatory BP, pulse wave velocity (PWV) and central BP obtained by applanation tonometry. Other endpoints were p-25(OH)D, p-Ca++, p-iPTH and components of the renin-angiotensin system. Plasma concentrations of renin, angiotensin II and aldosterone were measured using RIAs. Data were analyzed using unpaired t-test and Mann-Whitney test when appropriate.

Results: 112 patients (mean age 61 ± 10) with a baseline p-25(OH)D of 57 ± 26 nmol/l completed the study. Compared with placebo, cholecalciferol caused a significant increase in p-25(OH)D (62 nmol/l, p < 0.001) and p-Ca++ (0.01 mmol/l, p < 0.05), and a significant suppression of p-PTH (0.97 pmol/l, p < 0.001). No significant differences were observed in 24-h ambulatory BP.

However, in patients with p-25(OH)D <75 nmol/l (n = 92), the cholecalciferol group showed a borderline reduction in both systolic BP (3.7 mmHg, p = 0.08) and diastolic BP (2.7 mmHg, p = 0.02) compared to placebo.

Furthermore, in all patients, central systolic and diastolic BP was reduced 6.8 mmHg (p = 0.007) and 1.7 mmHg (p = 0.15), respectively, compared to placebo. No statistically significant difference between groups was observed in pulse wave velocity.

Conclusion: In hypertensive Caucasians residing at the 56th northern latitude, 75 ug of cholecalciferol daily during winter months caused a significant reduction in central systolic blood pressure. In a sub-analysis of patients with p-25(OH)D <75 nmol/l, a marginal reduction in both systolic and diastolic 24-h ambulatory BP was observed.

Effect of Vitamin D Supplementation on Blood Pressure in Blacks - Clinical Trial June 2013

Effect of Vitamin D Supplementation on Blood Pressure in Blacks Hypertension Journal, Clinical Trial, June 2013
Trial lasted only 3 months.
No loading dose, so unlikely to get a good level of vitamin D until the final weeks of the trial
Still - 4,000 IU daily reduced systolic pressure −4.0 mm Hg in Blacks

Hypertension also reduced by probiotics - but not as much as Vitamin D - July 2014

Anti-hypertensive drug ==> 40% increase of serious fall injury

  • Are Blood Pressure Drugs Worth the Falls? NYT April 2014
    more than 70 % of those over age 70 contend with high blood pressure
    85% of Medicare patients with hypertension took at least one type of blood pressure drug
    risk of serious fall injuries was significantly higher among those who took anti-hypertensives
    study of 5,000 patients avg age 80
    moderate users of hypertensives: serious fall injuries were 40 % higher

Preeclampsia during pregnancy (systolic blood pressure > 144mm and protein in urine)

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