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Review
, 9 (11), 885-901

Vitamin D Deficiency and Essential Hypertension

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Review

Vitamin D Deficiency and Essential Hypertension

Songcang Chen et al. J Am Soc Hypertens.

Abstract

Essential hypertension (EH) results when the balance between vasoconstriction and vasodilation is shifted in favor of vasoconstriction. This balance is controlled by the interaction of genetic and epigenetic factors. When there is an unstable balance, vitamin D deficiency as an epigenetic factor triggers a shift to the side of vasoconstriction. In this article, we critically analyze clinical findings on the effect of vitamin D on blood pressure, combined with progress in molecular mechanisms. We find that vitamin D repletion exerts a clinically significant antihypertensive effect in vitamin D-deficient EH patients. Of note, a few trials reported no antihypertensive effect from vitamin D due to suboptimal study design. Short-term vitamin D supplementation has no effect on blood pressure in normotensive subjects. This could explain the mixed results and may provide a theoretical basis for future trials to identify beneficial effects of vitamin D in intervention for EH.

Keywords: Essential hypertension; clinical trial; molecular mechanism; vitamin D.

Conflict of interest statement

All authors have read the journal's authorship agreement and publication policy and declare no conflict of interest.

Figures

Figure 1
Figure 1
Synthesis of natural product, vitamin D in the regulation of calcium, phosphorous, bone metabolism, BP and cardiovascular function. PT: Parathyroid glands. BP: blood pressure.
Figure 2
Figure 2
The effect of vitamin D supplementation on BP. A: When people have a stable balance between vasodilatory (V-Dil) and vasoconstrictory (V-Con) factors to maintain normal BP, vitamin D deficiency (D-Dif) and vitamin D supplementation (D-Sup) in a relatively short period have a minimal effect on BP. B: When people have an unstable balance between vasodilatory and vasoconstrictory factors, vitamin D deficiency becomes a risk trigger to promote the development of HTN at age >45 years; vitamin D repletion is able to reduce BP in this setting.

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