Joint Association of Low Vitamin D and Vitamin K Status With Blood Pressure and Hypertension

Hypertension. 2017 Jun;69(6):1165-1172. doi: 10.1161/HYPERTENSIONAHA.116.08869. Epub 2017 Apr 10.


Low vitamin D and K status are both associated with an increased cardiovascular risk. New evidence from experimental studies on bone health suggest an interaction between vitamin D and K; however, a joint association with vascular health outcomes is largely unknown. To prospectively investigate whether the combination of low vitamin D and K status is associated with higher systolic and diastolic blood pressure in 402 participants and with incident hypertension in 231 participants free of hypertension at baseline. We used data from a subsample of the Longitudinal Aging Study Amsterdam, a population-based cohort of Dutch participants aged 55 to 65 years. Vitamin D and K status were assessed by 25-hydroxyvitamin D and dp-ucMGP (dephosphorylated uncarboxylated matrix gla protein) concentrations (high dp-ucMGP is indicative for low vitamin K status) in stored samples from 2002 to 2003. Vitamin D and K status were categorized into 25-hydroxyvitamin D <50/≥50 mmol/L and median dp-ucMGP <323/≥323 pmol/L. During a median follow-up of 6.4 years, 62% of the participants (n=143) developed hypertension. The combination of low vitamin D and K status was associated with increased systolic 4.8 mm Hg (95% confidence interval, 0.1-9.5) and diastolic 3.1 mm Hg (95% confidence interval, 0.5-5.7) blood pressure compared with high vitamin D and K status (P for interaction =0.013 for systolic blood pressure and 0.068 for diastolic blood pressure). A similar trend was seen for incident hypertension: hazard ratio=1.62 (95% confidence interval, 0.96-2.73) for the low vitamin D and K group. The combination of low vitamin D and K status was associated with increased blood pressure and a trend for greater hypertension risk.

Keywords: 25-hydroxyvitamin D; blood pressure; epidemiology; incident hypertension; vitamin K status.

MeSH terms

  • Aging / physiology
  • Blood Pressure / physiology
  • Blood Pressure Determination
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / physiopathology
  • Cohort Studies
  • Confidence Intervals
  • Disease Progression
  • Female
  • Humans
  • Hypertension / epidemiology
  • Hypertension / etiology*
  • Hypertension / physiopathology
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Risk Assessment
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / complications*
  • Vitamin K Deficiency / blood
  • Vitamin K Deficiency / complications*