Department of Translational Medicine, Section of Internal and CardioRespiratory Medicine, University of Ferrara; Sant'Anna Hospital, 44100, Ferrara, Italy.
Aging Clin Exp Res. 2022 May;34(5):951-958. doi: 10.1007/s40520-021-01994-w. Epub 2021 Oct 10.
Over the latest years different studies have investigated the possible relationship between D deficiency and occurrence of orthostatic hypotension (OH), often reaching controversial results. We perform an update meta-analysis providing an update overview on the association between hypovitaminosis D and orthostatic hypotension (OH) in older adults.
Data extraction was independently performed by two authors and based upon predefined criteria. The meta-analysis was performed using a random-effects model. Statistical heterogeneity between groups was measured using the Higgins I2 statistic.
Eight investigations enrolling 16.326 patients (mean age 75.5 years) met the inclusion criteria and were considered for the analysis. Patients with vitamin D deficiency were more likely to have OH compared to those without (OR: 1.36, 95% CI 1.14-1.63, p = 0.0001, I2 = 43.6%). A further sub-analysis, based on three studies, estimating the risk of OH in patients with hypovitaminosis D receiving antihypertensive treatment, did not reach the statistical significance (OR: 1.40, 95% CI 0.61-3.18, p = 0.418, I2 = 53.3%). Meta-regression performed using age (p = 0.12), BMI (p = 0.73) and gender (p = 0.62) as moderators did not reveal any statistical significance in influencing OH. Conversely, physical activity, Vitamin D supplementation and use of radioimmunoassay for the measurement of vitamin D serum levels showed a significant inverse relationship towards the risk of OH (Coeff.-0.09, p = 0.002, Coeff. - 0.12, p < 0.001 and Coeff. - 0.08, p = 0.03, respectively) among patients with hypovitaminosis D. A direct correlation between the administration of antihypertensive treatment and the risk of OH in older patients with low vitamin D level was observed (Coeff. 0.05, p < 0.001).
Hypovitaminosis D is significantly associated with OH in older adults and directly influence by the administration of antihypertensive drugs. Conversely, physical activity, vitamin D supplementation and use of radioimmunoassay as analytic method inversely correlated with the risk of OH in older patients.
近年来，不同的研究调查了 D 缺乏症与直立性低血压（OH）发生之间的可能关系，结果往往存在争议。我们进行了一项更新的荟萃分析，提供了老年人维生素 D 缺乏症与直立性低血压（OH）之间关联的最新概述。
数据提取由两名作者独立进行，并基于预设标准进行。荟萃分析使用随机效应模型进行。使用 Higgins I2 统计量测量组间的统计异质性。
八项纳入了 16326 名患者（平均年龄 75.5 岁）的研究符合纳入标准并被纳入分析。与不缺乏维生素 D 的患者相比，缺乏维生素 D 的患者更有可能患有 OH（OR：1.36，95%CI 1.14-1.63，p=0.0001，I2=43.6%）。进一步的亚分析，基于三项研究，估计接受抗高血压治疗的维生素 D 缺乏症患者发生 OH 的风险，没有达到统计学意义（OR：1.40，95%CI 0.61-3.18，p=0.418，I2=53.3%）。使用年龄（p=0.12）、BMI（p=0.73）和性别（p=0.62）作为调节剂进行的荟萃回归分析没有显示出任何统计学意义，表明其对 OH 无影响。相反，体力活动、维生素 D 补充剂和放射免疫测定法测量维生素 D 血清水平与维生素 D 缺乏症患者的 OH 风险呈显著负相关（Coeff.-0.09，p=0.002，Coeff.-0.12，p<0.001 和 Coeff.-0.08，p=0.03）。在维生素 D 水平较低的老年患者中，观察到抗高血压治疗的应用与 OH 风险之间存在直接相关性（Coeff.0.05，p<0.001）。
维生素 D 缺乏症与老年人的 OH 显著相关，并直接受抗高血压药物的影响。相反，体力活动、维生素 D 补充剂和放射免疫测定法作为分析方法与老年患者 OH 风险呈负相关。
