HypertensionHow does vitamin D work?

Vitamin D may lower blood pressure by affecting the renin angiotensin aldosterone system by suppressing renin123. Renin is a proteolytic enzyme secreted by the kidneys, which catalyzes the production of angiotensin, which, in turn, mediates extracellular fluid volume (blood plasma, lymph and interstitial fluid) and arterial vasoconstriction4

Parathyroid hormone (PTH) is associated with increased blood pressure5, with a larger effect on diastolic pressure6. PTH decreases with increasing serum 25(OH)D until about 30 ng/ml, after which there is little additional change7.

Vitamin D also increases insulin sensitivity8. Insulin resistance is a risk factor for hypertension910.

Arterial calcification increases blood pressure by stiffening the arterial walls11. Serum 25(OH)D levels are inversely correlated with arterial calcifications for those on hemodialysis12. Related to arterial stiffening is endothelial dysfunction. (The epithelium is the thin layer of cells that lines the interior surface of blood vessels.) Too little 25(OH)D13 and much calcium in the blood leads to endothelial dysfunction, which also contributes to increased blood pressure14. The paper by Rostand has a figure outlining his model for elevated blood pressure among African-Americans.

Page last edited: 09 May 2011

References

  1. Manrique, C. Lastra, G. Gardner, M. Sowers, J. R. The renin angiotensin aldosterone system in hypertension: roles of insulin resistance and oxidative stress. Med Clin North Am. 2009 May; 93 (3): 569-82.
  2. Pilz, S. Tomaschitz, A. Ritz, E. Pieber, T. R. Vitamin D status and arterial hypertension: a systematic review. Nat Rev Cardiol. 2009 Oct; 6 (10): 621-30.
  3. Verhave, G. Siegert, C. E. Role of vitamin D in cardiovascular disease. Neth J Med. 2010 Mar; 68 (3): 113-8.
  4. Ballermann, B. J. Zeidel, M. L. Gunning, M. E. Brenner, B. M. Vasoactive peptides and the kidney. The kidney. 1991; pp. 510-583.
  5. Hulter, H. N. Melby, J. C. Peterson, J. C. Cooke, C. R. Chronic continuous PTH infusion results in hypertension in normal subjects. J Clin Hypertens. 1986 Dec; 2 (4): 360-70.
  6. Fraser, A. Williams, D. Lawlor, D. A. Associations of serum 25-hydroxyvitamin D, parathyroid hormone and calcium with cardiovascular risk factors: analysis of 3 NHANES cycles (2001-2006). PLoS One. 2010; 5 (11): e13882.
  7. Lappe, J. M. Davies, K. M. Travers-Gustafson, D. Heaney, R. P. Vitamin D status in a rural postmenopausal female population. J Am Coll Nutr. 2006 Oct; 25 (5): 395-402.
  8. Nagpal, J. Pande, J. N. Bhartia, A. A double-blind, randomized, placebo-controlled trial of the short-term effect of vitamin D3 supplementation on insulin sensitivity in apparently healthy, middle-aged, centrally obese men. Diabet Med. 2009 Jan; 26 (1): 19-27.
  9. Player, M. S. Mainous, A. G., 3rd Diaz, V. A. Everett, C. J. Prehypertension and insulin resistance in a nationally representative adult population. J Clin Hypertens (Greenwich). 2007 Jun; 9 (6): 424-9.
  10. Kawamoto, R. Kohara, K. Tabara, Y. Abe, M. Kusunoki, T. Miki, T. Insulin resistance and prevalence of prehypertension and hypertension among community-dwelling persons. J Atheroscler Thromb. 2010 Feb 26; 17 (2): 148-55.
  11. Lee, H. Y. Oh, B. H. Aging and arterial stiffness. Circ J. 2010 Oct 25; 74 (11): 2257-62.
  12. Matias, P. J. Ferreira, C. Jorge, C. Borges, M. Aires, I. Amaral, T. Gil, C. Cortez, J. Ferreira, A. 25-Hydroxyvitamin D3, arterial calcifications and cardiovascular risk markers in haemodialysis patients. Nephrol Dial Transplant. 2009 Feb; 24 (2): 611-8.
  13. Sugden, J. A. Davies, J. I. Witham, M. D. Morris, A. D. Struthers, A. D. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabet Med. 2008 Mar; 25 (3): 320-5.
  14. Rostand, S. G. Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension. 1997 Aug; 30 (2 Pt 1): 150-6.