Effect of supplemental intake of cholecalciferol on blood pressure variability in antihypertensive therapy

Abstract

The aim of the study was to evaluate the impact of cholecalciferol supplementation on blood pressure (BP) in patients with arterial hypertension (AH) in the area of Blida (Algeria). A prospective, cohort, single-center study of 898 individuals with AH (54.1 ± 5.8 years) was performed. In addition to antihypertensive therapy every patient was recommended to take cholecalciferol 2000 IU/month. The duration of cholecalciferol supplementation was 3.5 ± 1.7 months. The duration of follow-up was 12.4 ± 1.2 months. The “dynamics” (d) index was calculated as a difference between values before and after administered therapy. At baseline office systolic (SBP) and diastolic BP (DBP) averaged at 164/91 mmHg. On the follow-up there were their significant ( P < 0.001) reduction and were 131/82 mmHg correspondingly. Target levels of office BP measurements were achieved in 78.1% for SBP and 89.5% for DBP. Serum 25(OH)D total at baseline was 12.4 ng/mL, at the end of the follow-up period was 48.4 ng/mL ( P < 0,01). Correlation relationship between dSBP and duration of cholecalciferol intake was established ( R = 0.47; P = 0.02). It was found that intake of diuretics (hydrochlorothiazide at a dose of 12.5 mg and higher) as part of combination of antihypertensive therapy influenced the dynamics of serum 25(OH)D (F = 4.4; P = 0.01) and its level ( F = 10.9; P = 0.01). The highest d25(OH)D was found in the group of patients without diuretics intake. dSBP value was highest (–31.5 ± 19.5) in the group receiving diuretics and cholecalciferol, which was significantly ( P < 0.001) different from the comparison group. No difference was found for the total amount of antihypertensive medication that was used at 6 and 12 months. The combined use of cholecalciferol at a dose of 2000 IU/month and diuretic therapy of patients with arterial hypertension allowed to obtain the greatest hypotensive effect on blood pressure.