From the Department of Medicine, Geriatrics Division (N.V., F.B., M.D.R., E.M., G.S.), Department of Medical and Surgical Sciences (S.Z., E.M.), and Department of Cardiac, Thoracic and Vascular Sciences, Biostatistics, Epidemiology, and Public Health Unit (E.P.), University of Padova, Padova, Italy; National Research Council, Aging Branch, Neuroscience Institute, Padova, Italy (S.Z., G.C., E.M.); Azienda Unità Locale Socio Sanitaria, Padova, Italy (M.-C.C.); and Internal Medicine Division, Azienda Ospedaliera, Padova, Italy (G.B.).
Hypertension. 2014 Sep;64(3):481-6. doi: 10.1161/HYPERTENSIONAHA.114.03143. Epub 2014 Jun 9.
Interest in the association between serum 25-hydroxyvitamin D (25OHD) and blood pressure has increased because recent research showed a close relationship between them, but there is still little information on the possible association between 25OHD and orthostatic hypotension. The aim of this study was to explore the relationship of 25OHD levels with any presence of orthostatic hypotension in a large group of older people. This study was part of the Progetto Veneto Anziani (Pro.V.A.), an Italian population-based cohort study involving people aged >65 years. In this cross-sectional work, we considered 2640 (1081 men and 1559 women) with a mean age of 73.8±6.8 years. Orthostatic hypotension was defined as a drop of ≤20 mm Hg in systolic or ≤10 mm Hg in diastolic blood pressure <3 minutes of orthostatism. Orthostatic hypotension was identified in 32.2% of the sample. The prevalence of orthostatic hypotension was higher in individuals with 25OHD levels <50 nmol/L, but this trend was not significant (P=0.13). Individuals who had orthostatic hypotension had significantly lower 25OHD levels than those who did not (75.0±51.4 versus 82.6±54.0 nmol/L; P<0.0001). On logistic regression analysis, the greater likelihood of individuals with lower 25OHD levels having orthostatic hypotension was no longer statistically significant after adjusting for potential confounders (odds ratio, 1.08; 95% confidence interval, 0.77-1.51; P=0.67 for people with 25OHD levels ≤25 nmol/L; odds ratio, 1.01; 95% confidence interval, 0.78-1.32; P=0.92 for those with 25OHD levels between 25 and 50 nmol/L). In conclusion, vitamin D is not significantly associated with any orthostatic hypotension in older people.
人们对血清 25-羟维生素 D（25OHD）与血压之间关联的兴趣日益增加，因为最近的研究表明两者之间存在密切关系，但关于 25OHD 与体位性低血压之间可能存在的关联，仍知之甚少。本研究旨在探讨 25OHD 水平与老年人中体位性低血压的任何存在之间的关系。本研究是意大利基于人群的 Progetto Veneto Anziani（Pro.V.A.）研究的一部分，涉及年龄 >65 岁的人群。在这项横断面研究中，我们考虑了 2640 名（1081 名男性和 1559 名女性）参与者，他们的平均年龄为 73.8±6.8 岁。体位性低血压定义为 3 分钟直立位后收缩压下降>20mmHg 或舒张压下降>10mmHg。在样本中，有 32.2%的人患有体位性低血压。25OHD 水平<50nmol/L 的个体中体位性低血压的患病率较高，但这种趋势没有统计学意义（P=0.13）。患有体位性低血压的个体的 25OHD 水平明显低于未患有体位性低血压的个体（75.0±51.4 与 82.6±54.0 nmol/L；P<0.0001）。在 logistic 回归分析中，在校正潜在混杂因素后，25OHD 水平较低的个体发生体位性低血压的可能性更大，这不再具有统计学意义（25OHD 水平≤25nmol/L 的个体比值比，1.08；95%置信区间，0.77-1.51；P=0.67；25OHD 水平在 25-50nmol/L 之间的个体比值比，1.01；95%置信区间，0.78-1.32；P=0.92）。总之，维生素 D 与老年人的任何体位性低血压均无显著相关性。
