Scragg Robert, Slow Sandy, Stewart Alistair W, Jennings Lance C, Chambers Stephen T, Priest Patricia C, Florkowski Christopher M, Camargo Carlos A, Murdoch David R
From the School of Population Health, University of Auckland, Auckland, New Zealand (R.S., A.W.S.); Department of Pathology, University of Otago, Christchurch, New Zealand (S.S., L.C.J., S.T.C., C.M.F., D.R.M.); Preventive and Social Medicine, University of Otago, Dunedin, New Zealand (P.C.P.); and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (C.A.C.).
Hypertension. 2014 Oct;64(4):725-30. doi: 10.1161/HYPERTENSIONAHA.114.03466. Epub 2014 Jun 30.
Previous randomized controlled trials of vitamin D supplementation and blood pressure (BP) mainly have given vitamin D for short periods (<6 months) or at low doses (400 IU per day). This study aims to determine whether long-term high-dose vitamin D taken for 18 months lowers BP. Adults were recruited from a healthcare organization or university into a double-blind controlled trial and randomized to receive either vitamin D3 200 000 IU for 2 months followed by 100 000 IU monthly up to 18 months (n=161) or placebo (n=161). BP was measured at baseline, 5, and 18 months. Subjects had a mean (SD) age of 47.6 (9.7) years, 75% were women, and 94% were of European ancestry (white). Mean (SD) 25-hydroxyvitamin D3 changed from 73 (22) nmol/L at baseline to 124 (28) nmol/L at 18 months in the vitamin D group, and from 71 (22) nmol/L to 56 (22) nmol/L in the placebo group. Mean BP was similar for the vitamin D and placebo groups at baseline (123.4/76.3 versus 122.6/75.6 mm Hg; respectively). The mean change (95% confidence interval) in BP at 18 months minus baseline in the vitamin D group compared with placebo group was -0.6 (-2.8 to 1.6) mm Hg for systolic (P=0.61) and 0.5 (-1.1, 2.2) mm Hg for diastolic (P=0.53). Long-term vitamin D supplementation, which increased mean 25-hydroxyvitamin D3 concentration >100 nmol/L for 18 months, had no effect on systolic or diastolic BP in predominantly white, healthy adults without severe vitamin D deficiency. Beneficial effects on BP cannot be ruled out for other populations.
先前关于补充维生素D与血压(BP)关系的随机对照试验主要是短期(<6个月)或低剂量(每日400国际单位)补充维生素D。本研究旨在确定长期高剂量服用维生素D 18个月是否能降低血压。从一家医疗保健机构或大学招募成年人参与一项双盲对照试验,并随机分为两组,一组接受维生素D3,前2个月每月服用200000国际单位,之后每月服用100000国际单位,共18个月(n = 161),另一组接受安慰剂(n = 161)。在基线、第5个月和第18个月测量血压。受试者的平均(标准差)年龄为47.6(9.7)岁,75%为女性,94%为欧洲血统(白人)。维生素D组的平均(标准差)25-羟基维生素D3浓度从基线时的73(22)nmol/L升至18个月时的124(28)nmol/L,安慰剂组则从71(22)nmol/L降至56(22)nmol/L。维生素D组和安慰剂组在基线时的平均血压相似(分别为123.4/76.3和122.6/75.6 mmHg)。与安慰剂组相比,维生素D组在18个月时收缩压的平均变化(95%置信区间)减去基线值为-0.6(-2.8至1.6)mmHg(P = 0.61),舒张压为0.5(-1.1,2.2)mmHg(P = 0.53)。在主要为白人、健康且无严重维生素D缺乏的成年人中,长期补充维生素D使平均25-羟基维生素D浓度在18个月内升高至>100 nmol/L,但对收缩压或舒张压没有影响。不能排除对其他人群血压有有益影响的可能性。