Section of Ageing and Health, Centre for Cardiovascular and Lung Biology, Division of Medical Sciences, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, Scotland.
J Hypertens. 2009 Oct;27(10):1948-54. doi: 10.1097/HJH.0b013e32832f075b.
Vitamin D insufficiency has been linked to hypertension and cardiovascular events in observational studies. It is unclear whether vitamin D supplementation can reduce blood pressure, and, if so, by how much.
We performed a systematic review and meta-analysis to examine whether vitamin D reduces blood pressure. Databases including MEDLINE, EMBASE, the Cumulative Index to Nursing and Allied Health Literature and the Cochrane library were searched, supplemented by searches of grey literature, unpublished trials and references from included studies. Studies were assessed by two reviewers independently according to a prespecified protocol. Interventions included activated vitamin D, unactivated vitamin D2 and D3 and ultraviolet B radiation.
Eleven randomized, controlled trials fulfilled the inclusion criteria. Studies were small and of variable methodological quality. Mean baseline blood pressure was more than 140/90 mmHg in eight studies. Meta-analysis of these eight studies showed a nonsignificant reduction in systolic blood pressure in the vitamin D group compared with placebo [-3.6 mmHg, 95% confidence interval (CI) -8.0 to 0.7]. A small, statistically significant reduction was seen in diastolic blood pressure (-3.1 mmHg, 95% CI -5.5 to -0.6). Subgroup analysis suggested that unactivated vitamin D produced a greater fall in systolic blood pressure than activated vitamin D (-6.2 mmHg, 95% CI -12.32 to -0.04, vs. +0.7 mmHg, 95% CI -4.8 to 6.2). No reduction in blood pressure was seen in studies examining patients who were normotensive at baseline.
We found weak evidence to support a small effect of vitamin D on blood pressure in studies of hypertensive patients.
在观察性研究中，维生素 D 不足与高血压和心血管事件有关。目前尚不清楚维生素 D 补充是否可以降低血压，如果可以，降低幅度有多少。
我们进行了系统评价和荟萃分析，以检查维生素 D 是否可以降低血压。检索了 MEDLINE、EMBASE、护理和联合健康文献累积索引以及 Cochrane 图书馆等数据库，并通过灰色文献、未发表试验以及纳入研究的参考文献进行补充搜索。研究由两位评审员根据预设方案独立评估。干预措施包括活性维生素 D、非活性维生素 D2 和 D3 以及紫外线 B 辐射。
有 11 项随机对照试验符合纳入标准。这些研究规模较小，方法学质量各不相同。八项研究的基线平均血压均高于 140/90mmHg。对这八项研究的荟萃分析显示，与安慰剂相比，维生素 D 组的收缩压无显著降低[-3.6mmHg，95%置信区间（CI）-8.0 至 0.7]。舒张压有较小但具有统计学意义的降低[-3.1mmHg，95%CI-5.5 至-0.6]。亚组分析表明，与活性维生素 D 相比，非活性维生素 D 降低收缩压的效果更大[-6.2mmHg，95%CI-12.32 至-0.04，vs.+0.7mmHg，95%CI-4.8 至 6.2]。在基线血压正常的患者中进行的研究未发现血压降低。
我们发现，在高血压患者的研究中，维生素 D 对血压的影响有微弱的证据支持。
