Institutes of Clinical Medicine, University of Tromsø, Tromsø, Norway.
Hypertension. 2010 Mar;55(3):792-8. doi: 10.1161/HYPERTENSIONAHA.109.143990. Epub 2010 Jan 11.
Vitamin D receptors have been detected in vascular smooth muscle cells, and 1,25-dihydroxyvitamin D inhibits the renin mRNA expression. Epidemiological studies show an inverse relation between serum 25-hydoxyvitamin D levels and blood pressure, and low serum 25-hydoxyvitamin D levels are reported to be predictors of future development of hypertension. This may indicate an important role for vitamin D in blood pressure regulation. In the present study, 25-hydoxyvitamin D was measured in sera collected in 1994 from 4125 subjects who did not use blood pressure medication, and thereafter measurement was repeated in 2008 for 2385 of these subjects. In sera from 1994 there was a significant decrease in age, body mass index, and systolic blood pressure and a significant increase in physical activity score across increasing 25-hydoxyvitamin D quartiles. After adjusting for sex, age, body mass index, and physical activity, the difference in systolic blood pressure between the lowest and highest serum 25-hydoxyvitamin D quartiles was 3.6 mm Hg. After adjustment for confounders, serum 25-hydoxyvitamin D from 1994 did not predict future hypertension or increase in blood pressure, nor was there any significant association between change in serum 25-hydoxyvitamin D from 1994 to 2008 and change in blood pressure. Our results do not support a causal role for vitamin D in blood pressure regulation, and large randomized clinical trials, preferably including subjects with hypertension and/or low serum 25-hydoxyvitamin D levels, are greatly needed to clarify whether vitamin D supplementation affects the blood pressure.
维生素 D 受体已在血管平滑肌细胞中被检测到，而 1,25-二羟维生素 D 抑制肾素 mRNA 的表达。流行病学研究表明，血清 25-羟维生素 D 水平与血压呈负相关，低血清 25-羟维生素 D 水平被报道为高血压未来发展的预测因子。这可能表明维生素 D 在血压调节中具有重要作用。在本研究中，测量了 1994 年未服用降压药物的 4125 名受试者血清中的 25-羟维生素 D，并在 2008 年对其中 2385 名受试者进行了重复测量。在 1994 年的血清中，随着 25-羟维生素 D 四分位值的增加，年龄、体重指数和收缩压显著降低，体力活动评分显著增加。在校正性别、年龄、体重指数和体力活动后，血清 25-羟维生素 D 最低和最高四分位值之间的收缩压差异为 3.6mmHg。在调整混杂因素后，1994 年血清 25-羟维生素 D 与未来高血压或血压升高无关，1994 年至 2008 年血清 25-羟维生素 D 的变化与血压的变化之间也没有显著关联。我们的结果不支持维生素 D 在血压调节中的因果作用，迫切需要进行大规模的随机临床试验，最好包括高血压和/或低血清 25-羟维生素 D 水平的受试者，以阐明维生素 D 补充是否会影响血压。
