Supplementation with vitamin D and blood pressure control: evidence-based review

Authors

  • Tiago Sá Pinho Interno de Medicina Geral e Familiar da Unidade de Saúde Familiar Águeda + Saúde, ACeS Baixo Vouga
  • Marta Carvalhinho Interna de Medicina Geral e Familiar da Unidade de Saúde Familiar Águeda + Saúde, ACeS Baixo Vouga
  • Telma Pinho Reis Interna de Medicina Geral e Familiar da Unidade de Saúde Familiar da Barrinha, ACeS Baixo Vouga

DOI:

https://doi.org/10.32385/rpmgf.v38i1.12966

Keywords:

Cholecalciferol, Arterial hypertension, Supplementation

Abstract

Objective: Vitamin D has many cardiovascular pleiotropic effects and its deficit seems to be associated with several cardiovascular diseases. The relationship between vitamin D supplementation and blood pressure values of hypertensive patients is controversial. The purpose of this review is to find evidence for the association between vitamin D supplementation for hypertensive adults and control of their blood pressure values.     

Data sources: National Guideline Clearinghouse, National Institute for Health and Care Excellence, Canadian Medical Association Practice Guidelines Infobase, The Cochrane Library, Database of Abstracts of Reviews of Effectiveness, Bandolier, Evidence-Based Medicine Online, and PubMed.    

Review method: A search for meta-analyzes (MA), systematic reviews, randomized controlled trials (RCT), and clinical guidelines published between June 2010 and June 2020, in Portuguese and English, was performed using the terms MESH Cholecalciferol, Blood pressure, and Vitamin D. To stratify the level of recommendation was used the Strength of Recommendation Taxonomy, of American Academy of Family Physicians

Results: One hundred and twenty-three articles were found and two MA and four RCT were selected. MA shows concordant results: there was no evidence of a statistically significant decrease in BP when supplemented with cholecalciferol, however, this was demonstrated when interventions for specific groups were adjusted, such as patients over 50 years old, obesity or high supplementation doses (> 800UI/day). Regarding the RCT, only two of them found relationships with statistical significance, while the remaining two failed to demonstrate a causal correlation.

Conclusions: The evidence of the association between cholecalciferol supplementation in hypertensive patients and blood pressure control is unclear. Some studies have been able to demonstrate that in specific populations it seems to act as an adjunct in the treatment of hypertension (SORT C).

Downloads

Download data is not yet available.

References

Kheiri B, Abdalla A, Osman M, Ahmed S, Hassan M, Bachuwa G. Vitamin D deficiency and risk of cardiovascular diseases: a narrative review. Clin Hypertens. 2018;24:9.

Vaidya A, Forman JP. Vitamin D and vascular disease: the current and future status of vitamin D therapy in hypertension and kidney disease. Curr Hypertens Rep. 2012;14(2):111-9.

Legarth C, Grimm D, Wehland M, Bauer J, Krüger M. The impact of vitamin D in the treatment of essential hypertension. Int J Mol Sci. 2018;19(2):455.

Al Mheid I, Quyyumi AA. Vitamin D and cardiovascular disease: controversy unresolved. J Am Coll Cardiol. 2017;70(1):89-100.

Carrara D, Bruno RM, Bacca A, Taddei S, Duranti E, Ghiadoni L, et al. Cholecalciferol treatment downregulates renin-angiotensin system and improves endothelial function in essential hypertensive patients with hypovitaminosid D. J Hypertens. 2016;34(11):2199-205.

World Health Organization. A global brief on hypertension: silent killer, global public health crisis - World Health Day 2013 [homepage]. Geneva: WHO; 2013. Available from: https://apps.who.int/iris/handle/10665/79059

Williams B, Mancia G, Spiering W, Rosei EA, Azizi M, Burnier M, et al. Wytyczne ESC/ESH dotyczące postępowania w nadciśnieniu tętniczym (2018) [2018 ESC/ESH Guidelines for the management of arterial hypertension]. Kardiol Pol. 2019;77(2):71-159. Polish

Al-Zahrani MK, Elnasieh AM, Alenezi FM, Almoushawah AA, Almansour M, Alshahrani F, et al. A 3-month oral vitamin D supplementation marginally improves diastolic blood pressure in Saudi patients with type 2 diabetes mellitus. Int J Clin Exp Med. 2014;7(12):5421-8.

Direção-Geral da Saúde. Prevenção e tratamento da deficiência de vitamina D: norma nº 004/2019, de 14/08/2019. Lisboa: DGS; 2019.

Ebell MH, Siwek J, Weiss BD, Woolf SH, Susman J, Ewigman B, et al. Strength of recommendation taxonomy (SORT): a patient-centered approach to grading evidence in the medical literature. Am Fam Physician. 2004;69(3):548-56.

Golzarand M, Shab-Bidar S, Koochakpoor G, Speakman R, Djafarian K. Effect of vitamin D3 supplementation on blood pressure in adults: an updated meta-analysis. Nutr Metab Cardiovasc Dis. 2016;26(8):663-73.

Mozaffari-Khosravi H, Loloei S, Mirjalili MR, Barzegar K. The effect of vitamin D supplementation on blood pressure in patients with elevated blood pressure and vitamin D deficiency: a randomized, double-blind, placebo-controlled trial. Blood Press Monit. 2015;20(2):83-91.

Scragg R, Slow S, Stewart AW, Jennings LC, Chambers ST, Priest PC, et al. Long-term high-dose vitamin D3 supplementation and blood pressure in healthy adults: a randomized controlled trial. Hypertension. 2014;64(4):725-30.

Larsen T, Mose FH, Bech JN, Hansen AB, Pedersen EB. Effect of cholecalciferol supplementation during winter months in patients with hypertension: a randomized, placebo-controlled trial. Am J Hypertens. 2012;25(11):1215-22.

Nasri H, Behradmanesh S, Ahmadi A, Rafieian-Kopaei M. Impact of oral vitamin D (cholecalciferol) replacement therapy on blood pressure in type 2 diabetes patients: a randomized, double-blind, placebo controlled clinical trial. J Nephropathol. 2014;3(1):29-33.

Pilz S, Gaksch M, Kienreich K, Grübler M, Verheyen N, Fahrleitner-Pammer A, et al. Effects of vitamin D on blood pressure and cardiovascular risk factors: a randomized controlled trial. Hypertension. 2015;65(6):1195-201.

He S, Hao X. The effect of vitamin D3 on blood pressure in people with vitamin D deficiency: a system review and meta-analysis. Medicine (Baltimore). 2019;98(19):e15284.

Tabesh M, Azadbakht L, Faghihimani E, Tabesh M, Esmaillzadeh A. Effects of calcium plus vitamin D supplementation on anthropometric measurements and blood pressure in vitamin D insufficient people with type 2 diabetes: a randomized controlled clinical trial. J Am Coll Nutr. 2015;34(4):281-9.

Witham MD, Price RJ, Struthers AD, Donnan PT, Messow CM, Ford I, et al. Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial. JAMA Intern Med. 2013;173(18):1672-9.

Forman JP, Scott JB, Ng K, Drake BF, Gonzalez Suarez E, Hayden DL, et al. Effect of vitamin D supplementation on blood pressure in blacks. Hypertension. 2013;61(4):779-85.

Gonçalves MC, Neto MM, Cavalcante IG, Sebadelhe VR, Souza MF, Neves JP, et al. 200.000 IU of vitamin D does not reduce resting blood pressure and inhibit post-exercise hypotension in elderly women: a pilot study. An Acad Bras Cienc. 2020;92(1):e20190227.

Cherif AB, Temmar M, Bennouar S, Bouamra A, Taleb A, Bouraghda A, et al. Effect of vitamin D on the variability of blood pressure in premenopausal and menopausal hypertensive women in the area of Blida (Algeria). Ann Cardiol Angeiol (Paris). 2018;67(3):191-7.

Judd SE, Raiser SN, Kumari M, Tangpricha V. 1,25-dihydroxyvitamin D3 reduces systolic blood pressure in hypertensive adults: a pilot feasibility study. J Steroid Biochem Mol Biol. 2010;121(1-2):445-7.

Arora P, Song Y, Dusek J, Plotnikoff G, Sabatine MS, Cheng S, et al. Vitamin D therapy in individuals with prehypertension or hypertension: the DAYLIGHT trial. Circulation. 2015;131(3):254-62.

Alagacone S, Verga E, Verdolini R, Saifullah SM. The association between vitamin D deficiency and the risk of resistant hypertension. Clin Exp Hypertens. 2020;42(2):177-80.

Sluyter JD, Camargo Jr CA, Stewart AW, Waayer D, Lawes CM, Toop L, et al. Effect of monthly, high-dose, long-term vitamin D supplementation on central blood pressure parameters: a randomized controlled trial substudy. J Am Heart Assoc. 2017;6(10):e006802.

Bressendorff I, Brandi L, Schou M, Nygaard B, Frandsen NE, Rasmussen K, et al. The effect of high dose cholecalciferol on arterial stiffness and peripheral and central blood pressure in healthy humans: a randomized controlled trial. PLoS One. 2016;11(8):e0160905.

Published

2022-03-11

How to Cite

Supplementation with vitamin D and blood pressure control: evidence-based review. (2022). Portuguese Journal of Family Medicine and General Practice, 38(1), 48-57. https://doi.org/10.32385/rpmgf.v38i1.12966