Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey

Am J Hypertens. 2007 Jul;20(7):713-9. doi: 10.1016/j.amjhyper.2007.01.017.


Background: Populations with low vitamin D status, such as blacks living in the US or UK, have increased blood pressure (BP) compared with whites. We analyzed the association between serum 25-hydroxyvitamin D (25OHD) and BP to determine whether low 25OHD explains any of the increased BP in blacks.

Methods: The Third US National Health and Nutrition Examination Survey (NHANES III) is a cross-sectional survey representative of the US civilian population during 1988 to 1994. Analyses were restricted to 12,644 people aged > or =20 years with measurements of BP and 25OHD, after excluding those on hypertensive medication.

Results: Adjusted mean serum 25OHD was lowest in non-Hispanic blacks (49 nmol/L), intermediate in Mexican Americans (68 nmol/L), and highest in non-Hispanic whites (79 nmol/L). When participants were divided into 25OHD quintiles, mean (standard error) systolic BP was 3.0 (0.7) mm Hg lower (P = .0004) and diastolic BP was 1.6 (0.6) mm Hg lower (P = .011) for participants in the highest quintile (25OHD > or =85.7 nmol/L) compared with the lowest (25OHD < or =40.4 nmol/L), adjusting for age, sex, ethnicity, and physical activity. Further adjustment for body mass index (BMI) weakened the inverse association between 25OHD and BP, which remained significant for systolic BP (P < .05). The inverse association between 25OHD and systolic BP was stronger in participants aged > or =50 years than younger (P = .021). Ethnic differences in 25OHD explained about half of the increased hypertension prevalence in non-Hispanic blacks compared with whites.

Conclusions: Vitamin D status, which is amenable to intervention by safely increasing sun exposure or vitamin D supplementation, was associated inversely with BP in a large sample representative of the US population.

MeSH terms

  • Adult
  • Aged
  • Blood Pressure / physiology*
  • Cross-Sectional Studies
  • Diastole / physiology
  • Ethnicity / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Systole / physiology
  • Vitamin D / analogs & derivatives*
  • Vitamin D / blood


  • Vitamin D
  • 25-hydroxyvitamin D