Abstract
Objective: Vitamin D and parathyroid hormone (PTH) may affect structure and function of left ventricle in patients with kidney disease. The aim of this study was to investigate associations of serum 25-hydroxyvitamin D (25(OH)D) and PTH concentrations with left ventricular hypertrophy in hypertensive patients. Methods: We examined 41 patients with essential hypertension (M/F 15/26, mean age=62.3±4.5 yrs), 32 of whom (81%) were receiving antihypertensive treatment. ABPM monitors (SpaceLabs 90207) were programmed to obtain measurements each 15 min. during the day (6.00-22.00) and each 30 min. nighttime. Anthropometric data were collected with standardized protocol. Two-dimensionally guided M-mode echocardiography (VIVID 7 GE Pro) was performed to measure left ventricular structure. Left ventricular mass index (LVMI) was calculated as LVM divided by body surface area. Serum 25(OH)D and intact PTH concentrations were measured. In our analyses we adjusted for covariables. Results: Based on the results of the echocardiographic examination, the study group was divided into patients with LVH (LVH+, n=19) and those without LVH (LVH-, n=22). No statistically significant difference was found between the two groups in terms of basic characteristics. The average 25(OH)D level was lower in LVH+ patients as compared to LVH- participants (18.7±8.9 vs. 31.6±9.4 ng/ml, p = 0.01), both in unadjusted and adjusted analyses. In unadjusted analysis, the average PTH level of LVH+ patients was higher than LVH- patients (85.3±14.2 vs. 56.9±30.8 pg/mL, P =0.03). However, in multivariate model, additional adjustment for 24-h systolic BP, this association was non-significant (p=0.12). Conclusion: Our results suggest that vitamin D deficiency could be related to development of left ventricular hypertrophy in hypertension. Left ventricular hyperthorphy is associated with higher parathyroid hormone, however the effect is mediated by blood pressure.
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