Vitamin D and Vascular Disease: The Current and Future Status of Vitamin D Therapy in Hypertension and Kidney Disease

Vaidya, Anand; Forman, John P.

doi:10.1007/s11906-012-0248-9

Cited by 35 publications

(24 citation statements)

References 91 publications

(85 reference statements)

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“…However, beyond some suggestive experimental and observational studies, a relative large number of recent metaanalyses of the available clinical data gives conflicting data about the Vitamin D effect on BP [56].…”

Section: Vitaminsmentioning

confidence: 99%

Nutraceuticals and Blood Pressure Control: Results from Clinical Trials and Meta-Analyses

Cicero

Colletti

2015

High Blood Press Cardiovasc Prev

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Beyond the well-known effects on blood pressure (BP) of the dietary approaches to stop hypertension (DASH) and the Mediterranean diets, a large number of studies has investigated the possible BP lowering effect of different dietary supplements and nutraceuticals, the most part of them being antioxidant agents with a high tolerability and safety profile. In particular relatively large body of evidence support the use of potassium, L-arginine, vitamin C, cocoa flavonoids, beetroot juice, coenzyme Q10, controlled-release melatonin, and aged garlic extract. However there is a need for data about the long-term safety of a large part of the above discussed products. Moreover further clinical research is advisable to identify between the available active nutraceuticals those with the best cost-effectiveness and risk-benefit ratio for a large use in general population with low-added cardiovascular risk related to uncomplicated hypertension.

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Section: Vitaminsmentioning

confidence: 99%

Nutraceuticals and Blood Pressure Control: Results from Clinical Trials and Meta-Analyses

Cicero

Colletti

2015

High Blood Press Cardiovasc Prev

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“…De Zeeuw et al , Larsen et al ., and Joergensen et al . have shown that paracalcitol therapy, a VDR agonist, can lower albuminuria in advanced chronic kidney disease with or without diabetes; however, whether this effect is attributable to RAAS activity reduction remains to be proved(14, 97-99). …”

Section: Introductionmentioning

confidence: 99%

The renin–angiotensin–aldosterone system and calcium-regulatory hormones

2015

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There is increasing evidence of a clinically relevant interplay between the renin-angiotensin-aldosterone system and calcium regulatory systems. Classically, the former is considered a key regulator of sodium and volume homeostasis while the latter is most often associated with skeletal health. However, emerging evidence suggests an overlap in regulatory control. Hyperaldosteronism and hyperparathyroidism represent pathophysiologic conditions that may contribute to or perpetuate each other; aldosterone regulates parathyroid hormone and associates with adverse skeletal complications, and parathyroid hormone regulates aldosterone and associates with adverse cardiovascular complications. As dysregulation in both systems is linked to poor cardiovascular and skeletal health, it is increasingly important to fully characterize how they interact in order to more precisely understand their impact on human health and potential therapies to modulate these interactions. This review describes the known clinical interactions between these two systems including observational and interventional studies. Specifically, we review studies describing the inhibition of renin activity by calcium and vitamin D, and a potentially bidirectional and stimulatory relationship between aldosterone and parathyroid hormone. Deciphering these relationships might clarify variability in outcomes research, inform the design of future intervention studies, and provide insight into the results of prior and on-going intervention studies. However, before these opportunities can be addressed, more effort must be placed on shifting observational data to the proof of concept phase. This will require reallocation of resources to conduct interventional studies and secure the necessary talent.

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“…Most have been summarized in recent reviews and meta-analyses. [5][6][7][8][9] To date, trials of vitamin D supplementation and BP have shown mixed results. One meta-analysis of 11 studies concluded that vitamin D was beneficial in people with elevated BP (defined as >140/90 mm Hg) but not in those with normal BP.…”

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confidence: 99%

Long-Term High-Dose Vitamin D ₃ Supplementation and Blood Pressure in Healthy Adults

et al. 2014

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E levated blood pressure (BP) is a major risk factor for cardiovascular disease. There is accumulating evidence from meta-analyses of cohort studies that vitamin D deficiency, as measured by low serum levels of 25-hydroxyvitamin D, 25(OH) D, predicts increased risk of all-cause mortality, cardiovascular disease, and hypertension.1-3 Uncertainty remains, however, as to whether low vitamin D status is a true cause of these outcomes or simply a marker of other lifestyle variable(s), such as physical inactivity and obesity, which are the actual causes of these diverse outcomes. This scepticism was strengthened by the release of the 2011 Institute of Medicine report, which concluded that: (1) vitamin D (with calcium) is only beneficial for bone health and not for other health outcomes, such as cardiovascular disease and hypertension; and (2) the bone benefits of vitamin D supplementation occur only in people with 25(OH)D levels <50 nmol/L. 4 The Institute of Medicine report supported calls for randomized controlled trials of high-dose vitamin D supplementation (eg, ≥2000 IU per day) to determine the causality of epidemiological associations between low vitamin D status and nonskeletal outcomes, such as cardiovascular disease and hypertension.More than 20 randomized controlled trials of vitamin D supplementation and BP have been published. Most have been summarized in recent reviews and meta-analyses. [5][6][7][8][9] To date, trials of vitamin D supplementation and BP have shown mixed results. One meta-analysis of 11 studies concluded that vitamin D was beneficial in people with elevated BP (defined as >140/90 mm Hg) but not in those with normal BP.5 Another meta-analysis of 10 trials found that vitamin D supplementation caused a nonsignificant reduction in systolic BP (−1.9 mm; 95% confidence interval, −4.2 to 0.4) but had no effect on diastolic BP. 6 In only 6 of these studies is BP clearly identified as a primary end point. 10-15Most randomized controlled trials gave vitamin D for periods <1 year (most <6 months) [10][11][12][13][16][17][18][19][20][21][22][23][24][25][26][27] and, therefore, are of limited use for addressing the efficacy of long-term vitamin D supplementation in preventing and treating hypertension. Only 7 trials of long-term (≥1 year) supplementation have been Abstract-Previous randomized controlled trials of vitamin D supplementation and blood pressure (BP) mainly have given vitamin D for short periods (<6 months) or at low doses (400 IU per day). This study aims to determine whether long-term high-dose vitamin D taken for 18 months lowers BP. Adults were recruited from a healthcare organization or university into a double-blind controlled trial and randomized to receive either vitamin D 3 200 000 IU for 2 months followed by 100 000 IU monthly up to 18 months (n=161) or placebo (n=161). BP was measured at baseline, 5, and 18 months. Subjects had a mean (SD) age of 47.6 (9.7) years, 75% were women, and 94% were of European ancestry (white

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Vitamin D and Vascular Disease: The Current and Future Status of Vitamin D Therapy in Hypertension and Kidney Disease

Cited by 35 publications

References 91 publications

Nutraceuticals and Blood Pressure Control: Results from Clinical Trials and Meta-Analyses

Nutraceuticals and Blood Pressure Control: Results from Clinical Trials and Meta-Analyses

The renin–angiotensin–aldosterone system and calcium-regulatory hormones

Long-Term High-Dose Vitamin D ₃ Supplementation and Blood Pressure in Healthy Adults

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Vitamin D and Vascular Disease: The Current and Future Status of Vitamin D Therapy in Hypertension and Kidney Disease

Cited by 35 publications

References 91 publications

Nutraceuticals and Blood Pressure Control: Results from Clinical Trials and Meta-Analyses

Nutraceuticals and Blood Pressure Control: Results from Clinical Trials and Meta-Analyses

The renin–angiotensin–aldosterone system and calcium-regulatory hormones

Long-Term High-Dose Vitamin D 3 Supplementation and Blood Pressure in Healthy Adults

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Long-Term High-Dose Vitamin D ₃ Supplementation and Blood Pressure in Healthy Adults