Abstract
Observational and experimental data reinforce the concept that vitamin D is associated with the pathogenesis of arterial hypertension. We investigated the effect of a single dose of 100,000 IU of cholecalciferol, in office blood pressure (BP), and 24-h ambulatory blood pressure monitoring (ABPM) in patients with type 2 diabetes mellitus (DM), hypertension, and hypovitaminosis D. Forty-three patients were randomized to a placebo or cholecalciferol group. BP was assessed by office measurements and 24-h ABPM, before and after intervention. At week 8, a greater decrease in median ABPM values was observed in cholecalciferol supplementation than in the placebo group for systolic 24-h (− 7.5 vs. − 1; P = 0.02), systolic daytime (− 7 vs. − 1; P = 0.007), systolic nighttime (− 7.0 vs. 3; P = 0.009), diastolic 24-h (− 3.5 vs. − 1; P = 0.037), and daytime DBP (− 5 vs. 0; P = 0.01). Office DBP was also reduced after vitamin D supplementation. A single dose of vitamin D3 improves BP in patients with type 2 diabetes, hypertension, and vitamin D insufficiency, regardless of vitamin D normalization. Vitamin D supplementation could be a valuable tool to treat patients with type 2 DM, hypertension, and hypovitaminosis D.Trial registration: Clinicaltrials.gov NCT 02204527.
Highlights
Observational and experimental data reinforce the concept that vitamin D is associated with the pathogenesis of arterial hypertension[1,2,3,4,5]
We demonstrate that a single dose of cholecalciferol improves blood pressure (BP) in a short period of supplementation in patients with type 2 diabetes mellitus (DM) with hypertension and 25(OH)D < 20 ng/ml, regardless of vitamin D 3 normalization
In this sample of patients with type 2 DM, hypertension, and 25(OH)D < 20 ng/ml, the administration of a single dose of cholecalciferol resulted in clinically significant decreases in BP
Summary
Observational and experimental data reinforce the concept that vitamin D is associated with the pathogenesis of arterial hypertension[1,2,3,4,5]. Previous meta-analyses showed mixed effects on BP with supplementation of vitamin D in a dults[7,8,9]. Some of these metaanalyses included studies that examined the effects of different types of vitamin D (1-α-hydroxylated vitamin D derivatives or calcitriol, paricalcitol; and ergocalciferol or cholecalciferol), as well as a different access (oral, intramuscular, and parenteral vitamin D)[8]. Improved serum 25(OH) D concentrations in hypertensive individuals who had insufficient vitamin D were associated with improved control of systolic and diastolic BP and conferred a significant risk reduction for h ypertension[4,5]. By office and ambulatory blood pressure monitoring (ABPM), in patients with type 2 DM, hypertension, and hypovitaminosis D after 8 weeks of supplementation
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