Vitamin D status and blood pressure in children and adolescents: a systematic review of observational studies

Abstract

Background Childhood hypertension is a growing public health problem. Simultaneously, hypovitaminosis D is widespread in this population and could be associated with hypertension. This study systematically reviewed the literature on the relationship between vitamin D status and blood pressure (BP) in children and adolescents. Methods Following the PRISMA guidelines, PUBMED, MEDLINE, CINAHL, EMBASE, Cochrane Library, and ClinicalTrials.gov and the gray literature without language or time restrictions were searched. We included observational studies, assessed their risk of bias, and extracted data on population characteristics, vitamin D status and BP measurements, and the association between the two variables. A narrative analysis of the studies was performed. Results In total, 85 studies were included. Prospective cohort studies showed no association between vitamin D and BP, and generally, they were flawed. Also, the majority of non-prospective cohort studies (cross-sectional, retrospective, case-control) did not report an association between vitamin D and BP. They were mostly flawed regarding BP measurement and adjusting to potential confounders. Conclusion The results on the relationship between vitamin D status and BP in children and adolescents varied between the studies, and mainly pointed towards lack of association.

Low socioeconomic status predicts vitamin D status in a cross-section of Irish children

“…Furthermore, 55⋅5 % of children had a 25 (OH)D below 50 nmol/l in winter. This figure is identical (55⋅3 %) to the recent finding in children (n = 47, age [7][8][9][10][11] living in Northern Ireland between November and March (21) . While the prevalence of deficiency/insufficiency varied by season in the under 12s, the difference was not significant, but is likely explained by the small sample size and lack of statistical power.…”

“…For example, it may be important in fetal epigenetic programming of respiratory conditions in childhood (7) and has been associated with language and motor skill development, and risk of autism and ADHD (8,9) . Deficiency in childhood has been associated in some studies with extra-skeletal diseases (9) such as hypertension (10) , diabetes (11,12) , depression (13) , dental caries (14) , atopy and asthma (15,16) . Additionally, vitamin D might support childhood immune function with evidence suggesting a protective effect against respiratory tract infections.…”

Dietary Magnesium Intake Modifies the Association Between Vitamin D and Systolic Blood Pressure: Results From NHANES 2007–2014

“…In addition, Sakamoto R found that 25(OH)D levels were negatively correlated with systolic blood pressure, but the relationship between serum 25(OH)D and diastolic blood pressure was non-significant ( 10 ). However, a prospective cohort study by Myriam Abboud showed no association between vitamin D and BP ( 11 ). The differences in the results of the studies may be attributed to potential effect modifiers or confounding factors that have not been fully considered, such as dietary magnesium intake.…”

Dietary Magnesium Intake Modifies the Association Between Vitamin D and Systolic Blood Pressure: Results From NHANES 2007-2014.

“…Studies in animals and humans suggested that VDD can activate the renin-angiotensin system (RAS), which promotes the development of hypertension [9].In addition, Sakamoto R found that 25(OH)D levels were negatively correlated with systolic blood pressure, but the relationship between serum 25(OH)D and diastolic blood pressure was non-signi cant [10]. However, a prospective cohort study by Myriam Abboud showed no association between vitamin D and BP [11]. The differences in results of the studies may be attributed to potential confounding factors which have not been fully considered, such as dietary magnesium intake.…”