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Optimal vitamin D status attenuates the age-associated increase in systolic blood pressure in white Americans: results from the third National Health and Nutrition Examination Survey^1,2,3

¹ From the Nutrition and Health Sciences Program, Graduate Division of Biological and Biomedical Sciences (SEJ, TRZ, and VT), the Divisions of Endocrinology, Diabetes, and Lipids (MSN, TRZ, and VT) and Cardiology (PWFW), Department of Medicine, Emory University School of Medicine, Atlanta, GA

Background: The prevalences of both hypertension and vitamin D insufficiency are high in the United States. Recent clinical trials and animal studies have suggested that vitamin D insufficiency may be associated with elevated blood pressure.

Objective: With cross-sectional data, we sought to determine whether vitamin D concentrations were related to systolic blood pressure (SBP) in the third National Health and Nutrition Examination Survey (1988–1992).

Design: Blood pressure was classified with 5 categories from the Joint National Committee 7 with a sixth category added to distinguish participants with normotensive SBP (<110 mm Hg) from those with high-normal SBP (110–119 mm Hg). We used predicted marginals to estimate the conditional means of serum 25 hydroxyvitamin D [25(OH)D] and to test for trend across blood pressure categories. We used linear regression to explore the association between vitamin D, blood pressure, and age.

Results: Lower 25(OH)D concentrations were associated with a higher blood pressure category in whites (P < 0.001); however, when controlling for age, the association was no longer significant. Concentrations of 25(OH)D > 80 nmol/L decreased the age-related increase in SBP by 20% compared with participants having 25(OH)D concentrations < 50 nmol/L (P < 0.001). Only 8% of blacks had 25(OH)D concentrations > 80 nmol/L.

Conclusions: SBP is inversely associated with serum vitamin D concentrations in nonhypertensive white persons in the United States. This observation provides a rationale for studies on the potential effects of vitamin D supplementation as a method to reduce SBP in persons at risk of hypertension.

Key Words: Systolic blood pressure • vitamin D • hypovitaminosis D • hypertension • aging • NHANES

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