School of Population Health, University of Auckland, New Zealand
Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
J Am Heart Assoc. 2017 Oct 24;6(10):e006802. doi: 10.1161/JAHA.117.006802.
The effects of monthly, high-dose, long-term (≥1-year) vitamin D supplementation on central blood pressure (BP) parameters are unknown.
A total of 517 adults (58% male, aged 50-84 years) were recruited into a double-blinded, placebo-controlled trial substudy and randomized to receive, for 1.1 years (median; range: 0.9-1.5 years), either (1) vitamin D 200 000 IU (initial dose) followed 1 month later by monthly 100 000-IU doses (n=256) or (2) placebo monthly (n=261). At baseline (n=517) and follow-up (n=380), suprasystolic oscillometry was undertaken, yielding aortic BP waveforms and hemodynamic parameters. Mean deseasonalized 25-hydroxyvitamin D increased from 66 nmol/L (SD: 24) at baseline to 122 nmol/L (SD: 42) at follow-up in the vitamin D group, with no change in the placebo group. Despite small, nonsignificant changes in hemodynamic parameters in the total sample (primary outcome), we observed consistently favorable changes among the 150 participants with vitamin D deficiency (<50 nmol/L) at baseline. In this subgroup, mean changes in the vitamin D group (n=71) versus placebo group (n=79) were -5.3 mm Hg (95% confidence interval [CI], -11.8 to 1.3) for brachial systolic BP (=0.11), -2.8 mm Hg (95% CI, -6.2 to 0.7) for brachial diastolic BP (=0.12), -7.5 mm Hg (95% CI, -14.4 to -0.6) for aortic systolic BP (=0.03), -5.7 mm Hg (95% CI, -10.8 to -0.6) for augmentation index (=0.03), -0.3 m/s (95% CI, -0.6 to -0.1) for pulse wave velocity (=0.02), -8.6 mm Hg (95% CI, -15.4 to -1.9) for peak reservoir pressure (=0.01), and -3.6 mm Hg (95% CI, -6.3 to -0.8) for backward pressure amplitude (=0.01).
Monthly, high-dose, 1-year vitamin D supplementation lowered central BP parameters among adults with vitamin D deficiency but not in the total sample.
URL: http://www.anzctr.org.au. Unique identifier: ACTRN12611000402943.
每月、高剂量、长期（≥1 年）维生素 D 补充对中心血压（BP）参数的影响尚不清楚。
共有 517 名成年人（58%为男性，年龄 50-84 岁）被招募入一项双盲、安慰剂对照试验的子研究，并随机分为两组，接受为期 1.1 年（中位数；范围：0.9-1.5 年）的治疗：（1）维生素 D 200000IU（初始剂量），1 个月后每月 100000IU 剂量（n=256），或（2）每月安慰剂（n=261）。在基线（n=517）和随访（n=380）时，使用超脉冲振荡法进行主动脉 BP 波形和血流动力学参数检测。维生素 D 组的 25-羟维生素 D 平均去季节性水平从基线时的 66 nmol/L（SD：24）增加到随访时的 122 nmol/L（SD：42），而安慰剂组无变化。尽管在总样本中（主要结局）血流动力学参数有小但无统计学意义的变化，但我们观察到在基线时有维生素 D 缺乏症（<50 nmol/L）的 150 名参与者中，存在一致的有利变化。在该亚组中，与安慰剂组相比，维生素 D 组的平均变化（n=71）为：肱动脉收缩压（=0.11）降低 5.3mmHg（95%CI：-11.8 至 1.3），肱动脉舒张压（=0.12）降低 2.8mmHg（95%CI：-6.2 至 0.7），主动脉收缩压（=0.03）降低 7.5mmHg（95%CI：-14.4 至 -0.6），增强指数（=0.03）降低 5.7mmHg（95%CI：-10.8 至 -0.6），脉搏波速度（=0.02）降低 0.3m/s（95%CI：-0.6 至 -0.1），峰值储备压（=0.01）降低 8.6mmHg（95%CI：-15.4 至 -1.9），后向压力幅度（=0.01）降低 3.6mmHg（95%CI：-6.3 至 -0.8）。
在有维生素 D 缺乏症的成年人中，每月、高剂量、1 年的维生素 D 补充可降低中心 BP 参数，但在总样本中无此作用。
