From the Division of Endocrinology and Metabolism, Department of Internal Medicine (S.P., M.G., K.K., A.F.P., G.T., B.O.-P., V.S., F.A., J.M., E.L.), Department of Cardiology (M.G., N.V., A.T.), and Clinical Institute of Medical and Chemical Laboratory Diagnostics (H.S., A.M., W.M.), Medical University of Graz, Graz, Austria; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands (S.P., J.M.D.); Division of Nephrology, Department of Medicine I, University of Würzburg, Würzburg, Germany (C.D.); Department of Radiology, Dalio Institute of Cardiovascular Imaging, New York-Presbyterian Hospital and the Weill Cornell Medical College (B.o.H.), NY; Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr University Bochum, Bad Oeynhausen, Germany (A.Z.); Synlab Academy, Synlab Services GmbH, Mannheim, Germany (W.M.); Specialist Clinic for Rehabilitation Bad Aussee, Bad Aussee, Austria (A.T.); and Department of Cardiology, Campus Virchow, Charité University, Berlin, Germany (A.T.).
Hypertension. 2015 Jun;65(6):1195-201. doi: 10.1161/HYPERTENSIONAHA.115.05319. Epub 2015 Mar 23.
Vitamin D deficiency is a risk factor for arterial hypertension, but randomized controlled trials showed mixed effects of vitamin D supplementation on blood pressure (BP). We aimed to evaluate whether vitamin D supplementation affects 24-hour systolic ambulatory BP monitoring values and cardiovascular risk factors. The Styrian Vitamin D Hypertension Trial is a single-center, double-blind, placebo-controlled study conducted from June 2011 to August 2014 at the endocrine outpatient clinic of the Medical University of Graz, Austria. We enrolled 200 study participants with arterial hypertension and 25-hydroxyvitamin D levels below 30 ng/mL. Study participants were randomized to receive either 2800 IU of vitamin D3 per day as oily drops (n=100) or placebo (n=100) for 8 weeks. Primary outcome measure was 24-hour systolic BP. Secondary outcome measures were 24-hour diastolic BP, N-terminal-pro-B-type natriuretic peptide, QTc interval, renin, aldosterone, 24-hour urinary albumin excretion, homeostasis model assessment-insulin resistance, triglycerides, high-density lipoprotein cholesterol, and pulse wave velocity. A total of 188 participants (mean [SD] age, 60.1 [11.3] years; 47% women; 25-hydroxyvitamin D, 21.2 [5.6] ng/mL) completed the trial. The mean treatment effect (95% confidence interval) for 24-hour systolic BP was -0.4 (-2.8 to 1.9) mm Hg (P=0.712). Triglycerides increased significantly (mean change [95% confidence interval], 17 [1-33] mg/dL; P=0.013), but no further significant effects were observed for secondary outcomes. Vitamin D supplementation in hypertensive patients with low 25-hydroxyvitamin D has no significant effect on BP and several cardiovascular risk factors, but it was associated with a significant increase in triglycerides.
URL: http://www.clinicaltrials.gov. Unique identifier: NCT02136771.
评估维生素 D 补充是否会影响 24 小时收缩压动态血压监测值和心血管危险因素。
这是一项在奥地利格拉茨医科大学内分泌门诊进行的单中心、双盲、安慰剂对照研究，于 2011 年 6 月至 2014 年 8 月期间开展。研究纳入了 200 例患有动脉高血压且 25-羟维生素 D 水平低于 30ng/ml 的患者。将研究对象随机分为两组，每天分别接受 2800IU 的维生素 D3 油滴剂（n=100）或安慰剂（n=100）治疗 8 周。主要结局指标为 24 小时收缩压。次要结局指标包括 24 小时舒张压、N 末端前 B 型利钠肽、QTc 间期、肾素、醛固酮、24 小时尿白蛋白排泄、稳态模型评估-胰岛素抵抗、甘油三酯、高密度脂蛋白胆固醇和脉搏波速度。
共有 188 名参与者（平均[标准差]年龄 60.1[11.3]岁，47%为女性，25-羟维生素 D 水平 21.2[5.6]ng/ml）完成了试验。24 小时收缩压的平均治疗效果（95%置信区间）为-0.4（-2.8 至 1.9）mmHg（P=0.712）。甘油三酯显著升高（平均变化[95%置信区间]，17[1-33]mg/dL；P=0.013），但其他次要结局未见显著变化。
在低 25-羟维生素 D 的高血压患者中补充维生素 D 对血压和多种心血管危险因素没有显著影响，但与甘油三酯的显著升高有关。
