Can Vitamin D Deficiency Cause Hypertension?
SOURCE: Chen S, et al. Vitamin D deficiency and essential hypertension. J Am Soc Hypertens 2015;9:885-901.
Should we just cut to the chase and accept that vitamin D deficiency causes everything? That’s the way it seems these days. Chen et al made a convincing case for at least a potential etiologic role of vitamin D in development of hypertension.
Premises for consideration of vitamin D in relationship to hypertension include the observation that persons with less opportunity for vitamin D metabolism as a result of living in higher latitudes, having skin of color, or living in a colder climate with less outdoor sun exposure manifest a higher prevalence of essential hypertension. As part of “proof of concept,” one clinical trial enhanced vitamin D through ultraviolet B radiation in vitamin D-deficient patients, resulting in lower blood pressure.
While it should seem simple to test the vitamin D-hypertension relationship hypothesis, the results of 40 randomized trials addressing the issue have been mixed. The authors provided some explanation for this by noting that younger hypertensives (< 45 years of age) have more effective counterregulatory mechanisms for maintaining vascular tone than older patients, and, hence, vitamin D repletion in younger patients has less effect on blood pressure. Since most trials have incorporated populations of diverse age, younger patients may have diluted potential blood pressure effects of vitamin D repletion.
The authors noted that vitamin D deficiency tends to lead toward vasoconstriction, a common component of essential hypertension. Perhaps identification of particular populations that are strong responders (and elimination of non-responder groups from clinical trials) will define better a therapeutic role for the prevention or treatment of hypertension with vitamin D.
Vitamin D deficiency might be the root cause of all ills.
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