Renal Division and Kidney Clinical Research Institute, Brigham and Women's Hospital, 41 Ave Louis Pasteur, Suite 120, Boston, MA 02115, USA.
Hypertension. 2013 Apr;61(4):779-85. doi: 10.1161/HYPERTENSIONAHA.111.00659.
Blacks have significantly higher rates of hypertension than whites, and lower circulating levels of 25-hydroxyvitamin D. There are few data about the effect of vitamin D3 (cholecalciferol) supplementation on blood pressure in blacks. During 2 winters from 2008 to 2010, 283 blacks (median age, 51 years) were randomized into a 4-arm, double-blind trial for 3 months of placebo, 1000, 2000, or 4000 international units of cholecalciferol per day. At baseline, 3 months, and 6 months, systolic and diastolic pressure and 25-hydroxyvitamin D were measured. The 3-month follow-up was completed in 250 (88%) participants. The difference in systolic pressure between baseline and 3 months was +1.7 mm Hg for those receiving placebo, -0.66 mm Hg for 1000 U/d, -3.4 mm Hg for 2000 U/d, and -4.0 mm Hg for 4000 U/d of cholecalciferol (-1.4 mm Hg for each additional 1000 U/d of cholecalciferol; P=0.04). For each 1-ng/mL increase in plasma 25-hydroxyvitamin D, there was a significant 0.2-mm Hg reduction in systolic pressure (P=0.02). There was no effect of cholecalciferol supplementation on diastolic pressure (P=0.37). Within an unselected population of blacks, 3 months of oral vitamin D3 supplementation significantly, yet modestly, lowered systolic pressure. Future trials of vitamin D supplementation on blood pressure are needed to confirm these promising results, particularly among blacks, a population for whom vitamin D deficiency may play a more specific mechanistic role in the pathogenesis of hypertension.
黑人的高血压发病率明显高于白人,且循环 25-羟维生素 D 水平较低。关于维生素 D3(胆钙化醇)补充剂对黑人血压的影响的数据较少。在 2008 年至 2010 年的两个冬季,283 名黑人(中位数年龄为 51 岁)被随机分为 4 组、双盲试验,接受为期 3 个月的安慰剂、1000、2000 或 4000 国际单位的胆钙化醇/天。在基线、3 个月和 6 个月时测量收缩压和舒张压以及 25-羟维生素 D。250 名(88%)参与者完成了 3 个月的随访。与基线相比,接受安慰剂的患者收缩压增加了 1.7mmHg,每天服用 1000U 的患者收缩压降低了 0.66mmHg,每天服用 2000U 的患者收缩压降低了 3.4mmHg,每天服用 4000U 的患者收缩压降低了 4.0mmHg(每增加 1000U 的胆钙化醇收缩压降低 1.4mmHg;P=0.04)。血浆 25-羟维生素 D 每增加 1ng/ml,收缩压显著降低 0.2mmHg(P=0.02)。胆钙化醇补充对舒张压没有影响(P=0.37)。在一个未选择的黑人人群中,口服维生素 D3 补充剂 3 个月可显著但适度地降低收缩压。需要进一步的维生素 D 补充剂对血压的临床试验来证实这些有希望的结果,特别是在黑人中,维生素 D 缺乏可能在高血压发病机制中发挥更具体的机制作用。