Abstract

Background: Vitamin D (VD) deficiency has been related to several endocrine metabolic and cardiovascular diseases. The effect of VD supplementation on blood pressure (BP) in patients with diabetes is controversial.

Objective: The aim of this study was to evaluate high-dose vitamin D supplementation effects on blood pressure of normotensive patients with diabetes mellitus 1 (DM1) patients by 24-hour ambulatory blood pressure monitoring (ABPM).

Methods: We performed a clinical trial including 35 DM1 normotensive patients, who received doses of 4,000 or 10,000 IU/day of cholecalciferol for 12 weeks according to previous VD levels. They underwent 24-hour ABPM, along with glycated hemoglobin, creatine, lipids profile and PCRus dosage before and after VD supplementation.

Results: We found an expressive reduction of systolic and diastolic morning blood pressures (117±14 vs 112±14, p<0,05; 74±9 vs 70±10 mmHg, p<0,05, respectively) with no changes in other pressoric markers. Besides, we noticed a relationship between levels of VD after supplementation and diastolic morning blood pressure (r= -0,4; p<0.05).

Conclusion: Our study suggests an association between supplementation of high doses of vitamin D and the reduction of morning blood pressure in normotensive DM1 patients.

Keywords: Diabetes mellitus, type 1, vitamin D, blood pressure, blood pressure monitoring, ambulatory, cholecalciferol.

[1]
Reijven PLM, Soeters PB, Vitamin D, Vitamin D. A magic bullet or a myth? Clin Nutr 2020; S02615614: 30004-2.
[http://dx.doi.org/10.1016/j.clnu.2019.12.028] [PMID: 31959477]
[2]
Lin L, Zhang L, Li C, et al. Vitamin d and vitamin d receptor: New insights in the treatment of hypertension. Curr Protein Pept Sci 2019; 20(10): 984-95.
[http://dx.doi.org/10.2174/1389203720666190807130504] [PMID: 31389312]
[3]
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.
[http://dx.doi.org/10.1007/s11906-012-0248-9] [PMID: 22328068]
[4]
Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol 2017; 13(8): 466-79.
[http://dx.doi.org/10.1038/nrendo.2017.31] [PMID: 28387318]
[5]
Manson JE, Brannon PM, Rosen CJ, Taylor CL. Vitamin d. Vitamin d deficiency - is there really a pandemic? N Engl J Med 2016; 375(19): 1817-20.
[http://dx.doi.org/10.1056/NEJMp1608005] [PMID: 27959647]
[6]
Morvaridzadeh M, Sepidarkish M, Fazelian S, et al. Effect of calcium and vitamin d co-supplementation on blood pressure: A systematic review and meta-analysis. Clin Ther 2020; 42(3): e45-63.
[http://dx.doi.org/10.1016/j.clinthera.2020.01.005] [PMID: 32067744]
[7]
Zittermann A. Vitamin D and cardiovascular disease. Anticancer Res 2014; 34(9): 4641-8.
[PMID: 25202039]
[8]
Pilz S, Gaksch M, Kienreich K, et al. Effects of vitamin D on blood pressure and cardiovascular risk factors: A randomized controlled trial. Hypertension 2015; 65(6): 1195-201.
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.115.05319] [PMID: 25801871]
[9]
Chai W, Cooney RV, Franke AA, Bostick RM. Effects of calcium and vitamin D supplementation on blood pressure and serum lipids and carotenoids: A randomized, double-blind, placebo-controlled, clinical trial. Ann Epidemiol 2013; 23(9): 564-70.
[http://dx.doi.org/10.1016/j.annepidem.2013.07.003] [PMID: 23958407]
[10]
Strobel F, Reusch J, Penna-Martinez M, et al. Effect of a randomised controlled vitamin D trial on insulin resistance and glucose metabolism in patients with type 2 diabetes mellitus. Horm Metab Res 2014; 46(1): 54-8.
[PMID: 24198221]
[11]
Manson JE, Cook NR, Lee I-M, et al. Vital research group. Vitamin d supplements and prevention of cancer and cardiovascular disease. N Engl J Med 2019; 380(1): 33-44.
[http://dx.doi.org/10.1056/NEJMoa1809944] [PMID: 30415629]
[12]
Jeong HY, Park KM, Lee MJ, Yang DH, Kim SH, Lee S-Y. Vitamin D and Hypertension. Electrolyte Blood Press 2017; 15(1): 1-11.
[http://dx.doi.org/10.5049/EBP.2017.15.1.1] [PMID: 29042901]
[13]
Moreira JSR, de Paula TP, Sperb LF, Miller MEP, Azevedo MJ, Viana LV. Association of plasma vitamin D status with lifestyle patterns and ambulatory blood pressure monitoring parameters in patients with type 2 diabetes and hypertension. Diabetes Res Clin Pract 2018; 139: 139-46.
[http://dx.doi.org/10.1016/j.diabres.2018.02.038] [PMID: 29518487]
[14]
Martinez-Quinones P, McCarthy CG, Watts SW, et al. Hypertension induced morphological and physiological changes in cells of the arterial wall. Am J Hypertens 2018; 31(10): 1067-78.
[http://dx.doi.org/10.1093/ajh/hpy083] [PMID: 29788246]
[15]
Zhou Y, Zhang M, Ke S, Liu L. Hypertension outcomes of adrenalectomy in patients with primary aldosteronism: a systematic review and meta-analysis. BMC Endocr Disord 2017; 17(1): 61.
[http://dx.doi.org/10.1186/s12902-017-0209-z] [PMID: 28974210]
[16]
Hundemer GL. Primary Aldosteronism: Cardiovascular Outcomes Pre- and Post-treatment. Curr Cardiol Rep 2019; 21(9): 93.
[http://dx.doi.org/10.1007/s11886-019-1185-x] [PMID: 31352525]
[17]
Rynkowska-Kidawa M, Kidawa M, Kapusta J, Irzmański R, Matysiak R, Kowalski J. Assessment of the intima and media of carotid arteries in the course of hypertension in the elderly. Pol Merkuriusz Lek 2018; 45: 17-23.
[18]
Soneye MA, Adekanmi AJ, Obajimi MO, Aje A. Intima-media thickness of femoral arteries and carotids among an adult hypertensive Nigerian population: A case-control study to assess their use as surrogate markers of atherosclerosis. Ann Afr Med 2019; 18(3): 158-66.
[http://dx.doi.org/10.4103/aam.aam_57_18] [PMID: 31417017]
[19]
Felício JS, de Oliveira AF, Peixoto AS, et al. Albuminuria reduction after high dose of vitamin d in patients with type 1 diabetes mellitus: a pilot study. Front Endocrinol (Lausanne) 2017; 8: 199.
[http://dx.doi.org/10.3389/fendo.2017.00199] [PMID: 28855892]
[20]
National Kidney Fundation. Part 4. Definition and classification of stagesof chronic kidney disease. Am J Kidney Dis 2002; 39: S46-75.
[http://dx.doi.org/10.1053/ajkd.2002.30943]
[21]
Sypniewska G, Pollak J, Strozecki P, et al. 25-hydroxyvitamin D, biomarkers of endothelial dysfunction and subclinical organ damage in adults with hypertension. Am J Hypertens 2014; 27(1): 114-21.
[http://dx.doi.org/10.1093/ajh/hpt174] [PMID: 24042165]
[22]
Flynn JT, Kaelber DC, Baker-Smith CM, et al. Subcommittee on screening and management of high blood pressure in children. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 2017; 140(3): e20171904.
[http://dx.doi.org/10.1542/peds.2017-1904] [PMID: 28827377]
[23]
Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the american college of cardiology/american heart association task force on clinical practice guidelines. Hypertension 2018; 71(6): e13-e115.
[PMID: 29133356]
[24]
DiaSorin. Liaison 25 oh vitamin d total Assay https://www.diasorin.com/en/node/8476
[25]
American Diabetes Association. Standards of medical care in diabetes--2011. Diabetes Care 2011; 34(Suppl. 1): S11-61.
[http://dx.doi.org/10.2337/dc11-S011] [PMID: 21193625]
[26]
Levey AS, Stevens LA, Schmid CH, et al. CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration). A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150(9): 604-12.
[http://dx.doi.org/10.7326/0003-4819-150-9-200905050-00006] [PMID: 19414839]
[27]
Guo Q-H, Cheng Y-B, Zhang D-Y, et al. Comparison between home and ambulatory morning blood pressure and morning hypertension in their reproducibility and associations with vascular injury. Hypertension 2019; 74(1): 137-44.
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.12955] [PMID: 31104566]
[28]
Booth JN III, Jaeger BC, Huang L, et al. Morning blood pressure surge and cardiovascular disease events and all-cause mortality in blacks: the jackson heart study. Hypertension 2020; 75(3): 835-43.
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.119.14233] [PMID: 32008430]
[29]
Felício JS, Pacheco JT, Ferreira SR, et al. Reprodutibilidade da medida ambulatorial da pressão arterial em pacientes hipertensos com diabete melito tipo 2. Arq Bras Cardiol 2007; 88: 206-11.
[http://dx.doi.org/10.1590/S0066-782X2007000200012] [PMID: 17384839]
[30]
Zuo HJ, Song XT, Yang HX, Deng LQ, Wang JW. Early morning home blood pressure control among treated patients with controlled office blood pressure. J Clin Hypertens (Greenwich) 2019; 21(12): 1823-30.
[http://dx.doi.org/10.1111/jch.13736] [PMID: 31769172]
[31]
Ye X, Jia J, Zhang N, Ding H, Zhan Y. Associations of genetic polymorphisms of the vitamin D pathway with blood pressure in a Han Chinese population. Clin Exp Hypertens 2019; 41(5): 460-5.
[http://dx.doi.org/10.1080/10641963.2018.1506469] [PMID: 30192652]
[32]
Bilo G, Grillo A, Guida V, Parati G. Morning blood pressure surge: pathophysiology, clinical relevance and therapeutic aspects. Integr Blood Press Control 2018; 11: 47-56.
[http://dx.doi.org/10.2147/IBPC.S130277] [PMID: 29872338]
[33]
Mancia G, Verdecchia P. Clinical value of ambulatory blood pressure: evidence and limits. Circ Res 2015; 116(6): 1034-45.
[http://dx.doi.org/10.1161/CIRCRESAHA.116.303755] [PMID: 25767288]
[34]
Sheppard JP, Hodgkinson J, Riley R, Martin U, Bayliss S, McManus RJ. Prognostic significance of the morning blood pressure surge in clinical practice: a systematic review. Am J Hypertens 2015; 28(1): 30-41.
[http://dx.doi.org/10.1093/ajh/hpu104] [PMID: 25315474]
[35]
Di Gennaro F, D’Amato C, Morganti R, et al. Morning blood pressure surge is associated with autonomic neuropathy and peripheral vascular disease in patients with diabetes. J Hum Hypertens 2019. Available from: http://www.nature.com/articles/s41371-019-0270-3
[36]
Kario K, Pickering TG, Hoshide S, et al. Morning blood pressure surge and hypertensive cerebrovascular disease: role of the alpha adrenergic sympathetic nervous system. Am J Hypertens 2004; 17(8): 668-75.
[http://dx.doi.org/10.1016/j.amjhyper.2004.04.001] [PMID: 15288883]
[37]
Qu G-B, Wang L-L, Tang X, Wu W, Sun Y-H. The association between vitamin D level and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus: An update systematic review and meta-analysis. J Clin Transl Endocrinol 2017; 9: 25-31.
[http://dx.doi.org/10.1016/j.jcte.2017.04.001] [PMID: 29067266]
[38]
Muscogiuri G, Altieri B, Penna-Martinez M, Badenhoop K. Focus on vitamin D and the adrenal gland. Horm Metab Res 2015; 47(4): 239-46.
[http://dx.doi.org/10.1055/s-0034-1396893] [PMID: 25723858]
[39]
Tirabassi G, Salvio G, Altieri B, et al. Adrenal disorders: Is there Any role for vitamin D? Rev Endocr Metab Disord 2017; 18(3): 355-62.
[http://dx.doi.org/10.1007/s11154-016-9391-y] [PMID: 27761790]
[40]
Pani MA, Seissler J, Usadel KH, Badenhoop K. Vitamin D receptor genotype is associated with Addison’s disease. Eur J Endocrinol 2002; 147(5): 635-40.
[http://dx.doi.org/10.1530/eje.0.1470635] [PMID: 12444895]
[41]
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.
[http://dx.doi.org/10.3390/ijms19020455] [PMID: 29401665]
[42]
Li YC, Qiao G, Uskokovic M, et al. A negative endocrine regulator of the renin-angiotensin system and blood pressure. J Steroid Biochem Mol Biol 2004; 89-90(1-5): 387-92.
[http://dx.doi.org/10.1016/j.jsbmb.2004.03.004] [PMID: 15225806]
[43]
Beveridge LA, Witham MD. Controversy in the link between vitamin D supplementation and hypertension. Expert Rev Cardiovasc Ther 2015; 13(9): 971-3.
[http://dx.doi.org/10.1586/14779072.2015.1065729] [PMID: 26153248]
[44]
Mann MC, Hollenberg MD, Hanley DA, Ahmed SB. Vitamin D, the autonomic nervous system, and cardiovascular risk. Physiol Rep 2015; 3(4): e12349.
[http://dx.doi.org/10.14814/phy2.12349] [PMID: 25902783]
[45]
Wadhwania R. Is vitamin d deficiency implicated in autonomic dysfunction? J Pediatr Neurosci 2017; 12(2): 119-23.
[http://dx.doi.org/10.4103/jpn.JPN_1_17] [PMID: 28904566]
[46]
Beveridge LA, Khan F, Struthers AD, et al. Effect of vitamin d supplementation on markers of vascular function: A systematic review and individual participant meta‐analysis JAHA 2018.https://www.ahajournals.org/doi/10.1161/JAHA.117.008273
[47]
Zhang D, Cheng C, Wang Y, et al. Effect of vitamin d on blood pressure and hypertension in the general population: An update meta-analysis of cohort studies and randomized controlled trials. Prev Chronic Dis 2020.17E03
[http://dx.doi.org/10.5888/pcd17.190307] [PMID: 31922371]
[48]
Scragg R, Khaw KT, Murphy S. Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr 1995; 49(9): 640-6.
[PMID: 7498100]
[49]
Sluyter JD, Camargo CA, Stewart AW, et al. Effect of monthly, high‐dose, long‐term vitamin d supplementation on central blood pressure parameters: a randomized controlled trial substudy. JAHA 2017.https://www.ahajournals.org/doi/10.1161/JAHA.117.006802
[50]
Alvarez JA, Law J, Coakley KE, et al. High-dose cholecalciferol reduces parathyroid hormone in patients with early chronic kidney disease: A pilot, randomized, double-blind, placebo-controlled trial. Am J Clin Nutr 2012; 96(3): 672-9.
[http://dx.doi.org/10.3945/ajcn.112.040642] [PMID: 22854402]
[51]
Witham MD, Dove FJ, Khan F, Lang CC, Belch JJF, Struthers AD. Effects of vitamin D supplementation on markers of vascular function after myocardial infarction--a randomised controlled trial. Int J Cardiol 2013; 167(3): 745-9.
[http://dx.doi.org/10.1016/j.ijcard.2012.03.054] [PMID: 22459388]
[52]
Pfeifer M, Begerow B, Minne HW, Nachtigall D, Hansen C. 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 2001; 86(4): 1633-7.
[PMID: 11297596]
[53]
Rossini M, Gatti D, Viapiana O, et al. Short-term effects on bone turnover markers of a single high dose of oral vitamin D3. J Clin Endocrinol Metab 2012; 97(4): E622-6.
[http://dx.doi.org/10.1210/jc.2011-2448] [PMID: 22298802]
[54]
Bergman P, Lindh ÅU, Björkhem-Bergman L, Lindh JD. Vitamin d and respiratory tract infections: A systematic review and meta-analysis of randomized controlled trials. PLoS One 2013; 8(6): e65835.
[http://dx.doi.org/10.1371/journal.pone.0065835] [PMID: 23840373]
[55]
Beveridge LA, Struthers AD, Khan F, et al. D-pressure collaboration. 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.
[http://dx.doi.org/10.1001/jamainternmed.2015.0237] [PMID: 25775274]
[56]
Bressendorff I, Brandi L, Schou M, et al. The effect of high dose cholecalciferol on arterial stiffness and peripheral and central blood pressure in healthy humans: A randomized controlled trial 2016.
[http://dx.doi.org/10.1371/journal.pone.0160905]
[57]
Yiu Y-F, Yiu K-H, Siu C-W, et al. Randomized controlled trial of vitamin D supplement on endothelial function in patients with type 2 diabetes. Atherosclerosis 2013; 227(1): 140-6.
[http://dx.doi.org/10.1016/j.atherosclerosis.2012.12.013] [PMID: 23298824]
[58]
Mirhosseini N, Vatanparast H, Kimball SM. The Association between Serum 25(OH)D Status and Blood Pressure in Participants of a Community-Based Program Taking Vitamin D Supplements. Nutrients 2017; 9(11): 1244.
[http://dx.doi.org/10.3390/nu9111244] [PMID: 29135923]
[59]
Kimball S. Fuleihan Gel-H, Vieth R, Vitamin D. Vitamin D: a growing perspective. Crit Rev Clin Lab Sci 2008; 45(4): 339-414.
[http://dx.doi.org/10.1080/10408360802165295] [PMID: 18568854]
[60]
Margolis KL, Ray RM, Van Horn L, et al. Women’s health initiative investigators. Effect of calcium and vitamin d supplementation on blood pressure: the women’s health initiative randomized trial. Hypertension 2008; 52(5): 847-55.
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.108.114991] [PMID: 18824662]
[61]
Zittermann A, Frisch S, Berthold HK, et al. Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers. Am J Clin Nutr 2009; 89(5): 1321-7.
[http://dx.doi.org/10.3945/ajcn.2008.27004] [PMID: 19321573]
[62]
Kario K, Pickering TG, Umeda Y, et al. Morning surge in blood pressure as a predictor of silent and clinical cerebrovascular disease in elderly hypertensives: a prospective study. Circulation 2003; 107(10): 1401-6.
[http://dx.doi.org/10.1161/01.CIR.0000056521.67546.AA] [PMID: 12642361]
[63]
Li Y, Thijs L, Hansen TW, et al. International database on ambulatory blood pressure monitoring in relation to cardiovascular outcomes investigators. Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations. Hypertension 2010; 55(4): 1040-8.
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.137273] [PMID: 20212273]
[64]
Altieri B, Muscogiuri G, Barrea L, et al. Does vitamin d play a role in autoimmune endocrine disorders? A proof of concept. Rev Endocr Metab Disord 2017; 18(3): 335-46.
[http://dx.doi.org/10.1007/s11154-016-9405-9] [PMID: 28070798]
[65]
Grammatiki M, Karras S, Kotsa K. The role of vitamin D in the pathogenesis and treatment of diabetes mellitus: A narrative review. Hormones (Athens) 2019; 18(1): 37-48.
[http://dx.doi.org/10.1007/s42000-018-0063-z] [PMID: 30255482]
[66]
Savastio S, Cadario F, Beux S, et al. Vitamin D and type i diabetes. Open J Rheumatol 2018; 12: 289-99.
[http://dx.doi.org/10.2174/1874312901812010289]
[67]
Vimaleswaran KS, Cavadino A, Berry DJ, et al. Lifelines cohort study investigators; international consortium for blood pressure (icbp); cohorts for heart and aging research in genomic epidemiology (charge) consortium; global blood pressure genetics (global bpgen) consortium; caroline hayward. Association of vitamin d status with arterial blood pressure and hypertension risk: A mendelian randomisation study. Lancet Diabetes Endocrinol 2014; 2(9): 719-29.
[http://dx.doi.org/10.1016/S2213-8587(14)70113-5] [PMID: 24974252]
[68]
Wilhelm M, Winkler A, Rief W, Doering BK. Effect of placebo groups on blood pressure in hypertension: A meta-analysis of beta-blocker trials. J Am Soc Hypertens 2016; 10(12): 917-29.
[http://dx.doi.org/10.1016/j.jash.2016.10.009] [PMID: 27865824]

© 2024 Bentham Science Publishers | Privacy Policy