CLINICAL RISK FACTORS FOR SEVERE ESSENTIAL ARTERIAL HYPERTENSION IN PATIENTS WITH VITAMIN D DEFICIENCY

Abstract

Objective: The aim of this study was to establish the role of clinical complains and symptoms as risk factors for severe essential arterial hypertension (EAH) in patients with vitamin D deficiency. Design and method: 100 EAH patients with target-organ damage, moderate, high-very high cardiovascular risk were involved in the case-control study. 79.0% females and 21.0% males, mean age 59.87 ± 8.02. They were tested for total serum 25-hydroxyvitamin D concentration (immune luminescent test “MAGLUMI”, “SNIB”, China). All recruited patients were taken history, underwent complex examination and divided into groups depending on level of vitamin D and BP. Control group included 60 practically healthy persons of relevant age. Results: Hypertensive patients with vitamin D deficiency complained on heart pain 14.23% (⇙2 = 2.17; p>0.05), arrythmias – 20.86% (2 = 3.86; p = 0.049), headache – by 27.89% (⇙2 = 7.34; p = 0.007), sleep disturbance – by 29.77% (⇙2 = 7.97; p = 0.005), weakness and fatigue – by 20,59% (⇙2 = 3.88; p = 0.049) more frequent, than patients with normal 25-hydroxyvitamin D concentration. The frequency of patients with fatal cardiovascular risk SCORE >5.0 with vitamin D deficiency prevailed the ones with a normal level of vitamin D – by 20.94% (⇙2 = 3.98; p = 0.046). The risk for arrhythmias, weakness and fatigue increases 1.5 times [OR–2.36; 95% CI OR:1.0–5.61; p0.049 and OR–2.40; 95% CI OR:1.0-5.79; p = 0.049], sleep disturbance, headache and overweight increases 1.7-2.35 times [OR–3.43; 95% CI OR: 1.43-8.22; p = 0.005 and [OR–3.63; 95% CI OR:1.39-9.49; p = 0.007] and [OR–11.50; 95%CI OR:1.33-99.33; p = 0.038], respectively) in patients with 2nd-3d degree of BP elevation and vitamin D deficiency. The fatal cardiovascular risk SCORE >5.0 increases 1.5 times [OR–2.34; 95% CI OR:1.01-5.45; p = 0.046] in hypertensive patients with vitamin D deficiency. Conclusions: Vitamin D deficiency in patients with EAH is associated with severe clinical symptoms: the risk for arrhythmias increases 1.5 times [OR–2.36; p = 0.049], weakness risk increases 1.7 times [OR–2.40; p = 0.049], sleep disturbance risk elevates almost twice [OR–3.43; p = 0.005], risk for headache escalates 2.35 times [OR–3.63; p = 0.007], fatal cardiovascular risk SCORE >5.0 is 1.5 times high [OR–2.34; p = 0.046], respectively.