Effects of Vitamin D Supplement on Blood Pressure: A Systematic Review_Chinese Journal of Evidence-Based Medicine

Authors：

ZHANG Nan ,  XU Xinjuan , ZHU Lepiya simayi

Hypertension Department, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, China;

Corresponding author：

XU Xinjuan, Email: zcxu2002@medmail.com.cn

Keywords：

Vitamin D; Blood pressure; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20130016

Video：

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Objective 　To systematically review the impact of vitamin D supplement on blood pressure, so as to provide a basis for clinical treatment.
Methods 　Such databases as The Cochrane Library (Issue 8, 2011), MEDLINE (1996 to August 2011), EMbase (1974 to August 2011), CBM (1989 to 2011), CNKI (1997 to August 2011) and VIP (1989 to 2011) were searched to collect the randomized controlled trials (RCTs) about the impact of vitamin D supplement on blood pressure. Two reviewers independently screened the literature according to the inclusion criteria, extracted the data and assessed the quality. Then the meta-analysis was performed using RevMan 5.0 software.
Results 　A total of 8 studies involving 907 participants were included. The methodological quality based on the improved Jadad scales displayed that, 7 studies scored 4 to 7 and only 1 study scored less than 4. The results of meta-analysis showed that compared with the placebo groups, vitamin D supplement had no significant difference in both systolic and diastolic blood pressure.
Conclusion 　Based on current research evidences, compared with placebo, vitamin D supplement has no marked impact on either systolic or diastolic blood pressure. Due to the lack of studies, this conclusion still needs to be proved by conducting more well designed, large sample, and multicenter RCTs.

Citation： ZHANG Nan,XU Xinjuan,ZHU Lepiya simayi. Effects of Vitamin D Supplement on Blood Pressure: A Systematic Review. Chinese Journal of Evidence-Based Medicine, 2013, 13(1): 86-92. doi: 10.7507/1672-2531.20130016 Copy

1.	Giovannucci E. The epidemiology of vitamin D and cancer incidence and mort ality:a review. Cancer Causes Control, 2005, 16(2): 83-95.
2.	Hayes CE. Vitamin D: a natural inhibitor of multiple sclerosis. Proc Nutr Soc, 2000, 59(11): 531-535.
3.	Cantorna MT, Zhu Y, Froicu M, et al. Vitamin D status, 1,25-dihydroxyvita -minD3 , and the immune system. Am J Clin Nutr, 2004, 80(6): 1717S-1720S.
4.	Cheung PS, Thompson NW, Brothers TE, et al. Effect of hyperparathyroidism on the control of diabetes mellitus. Surgery, 1986, 100(14): 1039-1047.
5.	Taylor WH. The prevalence of diabetes mellitus in patients with primary hyperpar -athyroidism and among their relatives. Diabet Med, 1991, 8(6): 683-687.
6.	Werner S, Hjern B, Sjoberg HE. Primary hyperparathyroidism: analysis of findings in a series of 129 patients. Acta Chir Scand, 1974, 140(12): 618-625.
7.	Almirall J, Vaqueiro M, Bar´e ML, et al. Association of low serum 25-hydroxyvitamin D levels and high arterial blood pressure in the elderly. Nephrol Dial Transplant, 2010, 25(1): 503-509.
8.	Holick MF. Vitamin D deficiency. N Eng J Med, 2007, 357(15): 266-281.
9.	Chalmers J, MacMahon S, Mancia G, et al. 1999 World Health Organization International Society of Hypertension Guidelines for the management of hypertension. Guidelines subcommittee of the World Health Organization. J Clin Exp Hypertens, 1999, 21(5-6): 1009-1060.
10.	Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials is blinding necessary? Control Clin Trials, 1996, 17(1): 1.
11.	Jorde R, Sneve M, Torjesen P, et al. No improvement in cardiovascular risk factors in overweight and obese subjects after supplementation with vitamin D3 for 1 year. J Intern Med, 2010, 267(12): 462-472.
12.	Zittermann A, Frisch S, Berthold HK, et al. Vitamin D supplementation enhances the beneficial effects of weight loss on cardio-vascular disease risk markers. Am J Clin Nutr, 2009, 89(2): 1321-1327.
13.	Nagpal J, Pande JN, Bhartia A. A double-blind, randomized, placebo-contr -olled trial of the short-term effect of vitamin D supplementation on insulin sensitivity in apparently healthy, middle-aged,centrally obese men. Diabet Med, 2009, 26(5): 19-27.
14.	Pfeifer M, Begerow B, Minne HW, et al. Effects of a short- term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab, 2001, 86(6): 1633-1637.
15.	Scragg R, Khaw KT, Murphy S. Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr, 1995, 49(10): 640-646.
16.	Pan WH, Wang CY, Li LA, et al. No significant effect of calcium and vitamin D supplementation on blood pressure and calcium metabolism in elderly Chinese. Chin J Physiol, 1993, 36(3): 85-94.
17.	Myrup B, Jensen GF, McNair P. Cardiovascular risk factors during estrogen -norethindrone and cholecalciferol treatment. Arch Intern Med, 1992, 152(12): 2265- 2268.
18.	Lind L, Wengle B, Wide L, et al. Reduction of blood pressure during long-term treatment with active vitamin D (alphacalcidol) is dependent on plasma renin activity and calcium status. A double-blind, placebo controlled study. Am J Hypertens, 1989, 2(3): 20-25.
19.	Oladipo CO, Egbe PE, Ibu JO, et al. Interactions between sodium intake, calcium supp lement, renal excretion and blood pressure in Sprague 2 dawley rats. Niger Postgrad Med J, 2006, 13(4): 2822-2901.
20.	Porsti I, Fan M, Koobi P, et al. High calcium diet down 2 regulates kidney angiotensin converting enzyme in experimental renal failure. Kidney Int, 2004, 66(6): 21552-21661.
21.	Massry SG, Smogorzewsk IM. The effects of serum calcium and parthyroid hormone and the interaction between them on blood pressure in normal subjects and in patients with chronic kidney failure. JR en Nutr, 2005, 15(1): 173-177.
22.	Griffith LE, Guyatt GH, Cook RJ, et al. The influence of dietary and nondietary calcium supplementation on blood pressure: an updated meta-analysis of randomized controlled trials. Am J Hypertens, 1999, 12(2): 84-92.
23.	Burgaz A, Orsini N, Susanna C, et al. Blood 25-hydroxyvitamin D concentration and hypertension:a meta-analysis. Journal of Hypertension, 2011, 29(6): 636-645.
24.	Hsu JJ, Tintut Y, Demer LL. Vitamin D and osteogenic differentiation in the artery wall. Clin J Am Soc Nephrol, 2008, 3(5): 1542-1547.
25.	Hatton DC, Xue H, DeMerritt JA, et al. 1,25(OH)2 vitamin D3-induced alterations in vascular reactivity in the spontaneously hypertensive. Am J Med Sci, 1994, 2(1): 154-158.
26.	Liel Y, Ulmer E, Shary J, et al. Low circulating vitamin D in obesity. Calcif Tissue Int, 1988, 43(13): 199-201.
27.	Compston JE, Vedi S, Ledger JE, et al. Vitamin D status and bone histomorphometry in gross obesity. Am J Clin Nutr, 1981, 34(23): 2359-2363.
28.	Hey H, Stockholm KH, Lund BJ, et al. Vitamin D deficiency in obese patients and changes in circulating vitamin D metabolites following jejunoileal bypass. Int J Obes, 1982, 6(4): 473-479.
29.	Hyldstrup L, Andersen T, McNair P, et al. Bone metabolism in obesity: changes related to severe overweight and dietary weight reduction. Acta Endocrinol, 1993, 129(3): 393-398.
30.	Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1, 25-dihydroxy vitamin D concentrations in healthy adults. The Journal of Clinical Endocrinology & Metabolism, 2004, 89(3): 1196-1199.
31.	Norman AW, Frankel BJ, Heldt AM, et al. Vitamin D deficiency inhibits pancreatic secretion of insulin. Science, 1980, 209(23): 823-825.
32.	Rammos G, Tseke P, Ziakka S. Vitamin D, the reninangiotensin system, and insulin resistance. International Urology and Nephrology, 2008, 40(2): 419-426.
33.	Geleijnse JM. Vitamin D and hypertension does the women’s health initiative solve the question? Hypertension, 2008, 52(3): 803-804.

1. Giovannucci E. The epidemiology of vitamin D and cancer incidence and mort ality:a review. Cancer Causes Control, 2005, 16(2): 83-95.
2. Hayes CE. Vitamin D: a natural inhibitor of multiple sclerosis. Proc Nutr Soc, 2000, 59(11): 531-535.
3. Cantorna MT, Zhu Y, Froicu M, et al. Vitamin D status, 1,25-dihydroxyvita -minD3 , and the immune system. Am J Clin Nutr, 2004, 80(6): 1717S-1720S.
4. Cheung PS, Thompson NW, Brothers TE, et al. Effect of hyperparathyroidism on the control of diabetes mellitus. Surgery, 1986, 100(14): 1039-1047.
5. Taylor WH. The prevalence of diabetes mellitus in patients with primary hyperpar -athyroidism and among their relatives. Diabet Med, 1991, 8(6): 683-687.
6. Werner S, Hjern B, Sjoberg HE. Primary hyperparathyroidism: analysis of findings in a series of 129 patients. Acta Chir Scand, 1974, 140(12): 618-625.
7. Almirall J, Vaqueiro M, Bar´e ML, et al. Association of low serum 25-hydroxyvitamin D levels and high arterial blood pressure in the elderly. Nephrol Dial Transplant, 2010, 25(1): 503-509.
8. Holick MF. Vitamin D deficiency. N Eng J Med, 2007, 357(15): 266-281.
9. Chalmers J, MacMahon S, Mancia G, et al. 1999 World Health Organization International Society of Hypertension Guidelines for the management of hypertension. Guidelines subcommittee of the World Health Organization. J Clin Exp Hypertens, 1999, 21(5-6): 1009-1060.
10. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials is blinding necessary? Control Clin Trials, 1996, 17(1): 1.
11. Jorde R, Sneve M, Torjesen P, et al. No improvement in cardiovascular risk factors in overweight and obese subjects after supplementation with vitamin D3 for 1 year. J Intern Med, 2010, 267(12): 462-472.
12. Zittermann A, Frisch S, Berthold HK, et al. Vitamin D supplementation enhances the beneficial effects of weight loss on cardio-vascular disease risk markers. Am J Clin Nutr, 2009, 89(2): 1321-1327.
13. Nagpal J, Pande JN, Bhartia A. A double-blind, randomized, placebo-contr -olled trial of the short-term effect of vitamin D supplementation on insulin sensitivity in apparently healthy, middle-aged,centrally obese men. Diabet Med, 2009, 26(5): 19-27.
14. Pfeifer M, Begerow B, Minne HW, et al. Effects of a short- term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab, 2001, 86(6): 1633-1637.
15. Scragg R, Khaw KT, Murphy S. Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr, 1995, 49(10): 640-646.
16. Pan WH, Wang CY, Li LA, et al. No significant effect of calcium and vitamin D supplementation on blood pressure and calcium metabolism in elderly Chinese. Chin J Physiol, 1993, 36(3): 85-94.
17. Myrup B, Jensen GF, McNair P. Cardiovascular risk factors during estrogen -norethindrone and cholecalciferol treatment. Arch Intern Med, 1992, 152(12): 2265- 2268.
18. Lind L, Wengle B, Wide L, et al. Reduction of blood pressure during long-term treatment with active vitamin D (alphacalcidol) is dependent on plasma renin activity and calcium status. A double-blind, placebo controlled study. Am J Hypertens, 1989, 2(3): 20-25.
19. Oladipo CO, Egbe PE, Ibu JO, et al. Interactions between sodium intake, calcium supp lement, renal excretion and blood pressure in Sprague 2 dawley rats. Niger Postgrad Med J, 2006, 13(4): 2822-2901.
20. Porsti I, Fan M, Koobi P, et al. High calcium diet down 2 regulates kidney angiotensin converting enzyme in experimental renal failure. Kidney Int, 2004, 66(6): 21552-21661.
21. Massry SG, Smogorzewsk IM. The effects of serum calcium and parthyroid hormone and the interaction between them on blood pressure in normal subjects and in patients with chronic kidney failure. JR en Nutr, 2005, 15(1): 173-177.
22. Griffith LE, Guyatt GH, Cook RJ, et al. The influence of dietary and nondietary calcium supplementation on blood pressure: an updated meta-analysis of randomized controlled trials. Am J Hypertens, 1999, 12(2): 84-92.
23. Burgaz A, Orsini N, Susanna C, et al. Blood 25-hydroxyvitamin D concentration and hypertension:a meta-analysis. Journal of Hypertension, 2011, 29(6): 636-645.
24. Hsu JJ, Tintut Y, Demer LL. Vitamin D and osteogenic differentiation in the artery wall. Clin J Am Soc Nephrol, 2008, 3(5): 1542-1547.
25. Hatton DC, Xue H, DeMerritt JA, et al. 1,25(OH)2 vitamin D3-induced alterations in vascular reactivity in the spontaneously hypertensive. Am J Med Sci, 1994, 2(1): 154-158.
26. Liel Y, Ulmer E, Shary J, et al. Low circulating vitamin D in obesity. Calcif Tissue Int, 1988, 43(13): 199-201.
27. Compston JE, Vedi S, Ledger JE, et al. Vitamin D status and bone histomorphometry in gross obesity. Am J Clin Nutr, 1981, 34(23): 2359-2363.
28. Hey H, Stockholm KH, Lund BJ, et al. Vitamin D deficiency in obese patients and changes in circulating vitamin D metabolites following jejunoileal bypass. Int J Obes, 1982, 6(4): 473-479.
29. Hyldstrup L, Andersen T, McNair P, et al. Bone metabolism in obesity: changes related to severe overweight and dietary weight reduction. Acta Endocrinol, 1993, 129(3): 393-398.
30. Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1, 25-dihydroxy vitamin D concentrations in healthy adults. The Journal of Clinical Endocrinology & Metabolism, 2004, 89(3): 1196-1199.
31. Norman AW, Frankel BJ, Heldt AM, et al. Vitamin D deficiency inhibits pancreatic secretion of insulin. Science, 1980, 209(23): 823-825.
32. Rammos G, Tseke P, Ziakka S. Vitamin D, the reninangiotensin system, and insulin resistance. International Urology and Nephrology, 2008, 40(2): 419-426.
33. Geleijnse JM. Vitamin D and hypertension does the women’s health initiative solve the question? Hypertension, 2008, 52(3): 803-804.

Chinese Journal of Evidence-Based Medicine

Effects of Vitamin D Supplement on Blood Pressure: A Systematic Review

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