1 年后维生素 D 对老年人血压、动脉僵硬度和心功能的影响：BEST-D（维生素 D 的生化功效和安全性试验）。
Effects of Vitamin D on Blood Pressure, Arterial Stiffness, and Cardiac Function in Older People After 1 Year: BEST-D (Biochemical Efficacy and Safety Trial of Vitamin D).
机构信息
Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, United Kingdom.
Hightown Surgery, Banbury, Oxfordshire, United Kingdom.
出版信息
J Am Heart Assoc. 2017 Oct 24;6(10):e005707. doi: 10.1161/JAHA.117.005707.
BACKGROUND
The relevance of vitamin D for prevention of cardiovascular disease is uncertain. The BEST-D (Biochemical Efficacy and Safety Trial of vitamin D) trial previously reported effects of vitamin D on plasma markers of vitamin D status, and the present report describes the effects on blood pressure, heart rate, arterial stiffness, and cardiac function.
METHODS AND RESULTS
This was a randomized, double-blind, placebo-controlled trial of 305 older people living in United Kingdom, who were allocated vitamin D 4000 IU (100 μg), vitamin D 2000 IU (50 μg), or placebo daily. Primary outcomes were plasma concentrations of 25-hydroxy-vitamin D and secondary outcomes were blood pressure, heart rate, and arterial stiffness in all participants at 6 and 12 months, plasma N-terminal prohormone of brain natriuretic peptide levels in all participants at 12 months, and echocardiographic measures of cardiac function in a randomly selected subset (n=177) at 12 months. Mean (SE) plasma 25-hydroxy-vitamin D concentrations were 50 (SE 2) nmol/L at baseline and increased to 137 (2.4), 102 (2.4), and 53 (2.4) nmol/L after 12 months in those allocated 4000 IU/d, 2000 IU/d of vitamin D, or placebo, respectively. Allocation to vitamin D had no significant effect on mean levels of blood pressure, heart rate, or arterial stiffness at either 6 or 12 months, nor on any echocardiographic measures of cardiac function, or plasma N-terminal prohormone of brain natriuretic peptide concentration at 12 months.
CONCLUSIONS
The absence of any significant effect of vitamin D on blood pressure, arterial stiffness, or cardiac function suggests that any beneficial effects of vitamin D on cardiovascular disease are unlikely to be mediated through these mechanisms.
CLINICAL TRIAL REGISTRATION
URL: https://www.clinicaltrialsregister.eu/ctr-search/search. Unique identifier: EudraCT number: 2011-005763-24a.
背景
维生素 D 对预防心血管疾病的相关性尚不确定。BEST-D（维生素 D 的生化功效和安全性试验）试验此前报道了维生素 D 对维生素 D 状态的血浆标志物的影响，本报告描述了其对血压、心率、动脉僵硬和心脏功能的影响。
方法和结果
这是一项在英国居住的 305 名老年人中进行的随机、双盲、安慰剂对照试验，他们每天接受维生素 D 4000IU（100μg）、维生素 D 2000IU（50μg）或安慰剂治疗。主要结局是所有参与者在 6 个月和 12 个月时的血浆 25-羟维生素 D 浓度，所有参与者在 12 个月时的血浆 N 端脑钠肽前体水平，以及在随机选择的亚组（n=177）中在 12 个月时的超声心动图心脏功能测量。基线时平均（SE）血浆 25-羟维生素 D 浓度为 50（SE 2）nmol/L，分别接受 4000IU/d、2000IU/d 维生素 D 或安慰剂治疗 12 个月后，分别增加至 137（2.4）、102（2.4）和 53（2.4）nmol/L。维生素 D 分配对 6 个月或 12 个月时的血压、心率或动脉僵硬的平均水平，或任何超声心动图心脏功能测量或血浆 N 端脑钠肽前体浓度在 12 个月时均无显著影响。
结论
维生素 D 对血压、动脉僵硬或心脏功能没有任何显著影响，这表明维生素 D 对心血管疾病的任何有益影响都不太可能通过这些机制介导。
临床试验注册
网址：https://www.clinicaltrialsregister.eu/ctr-search/search。独特标识符：EudraCT 编号：2011-005763-24a。
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