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Racial Disparity in Blood Pressure: is Vitamin D a Factor?

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Abstract

Background

Higher prevalence of hypertension among African Americans is a key cause of racial disparity in cardiovascular morbidity and mortality. Explanations for the difference in prevalence are incomplete. Emerging data suggest that low vitamin D levels may contribute.

Objective

To assess the contribution of vitamin D to racial disparity in blood pressure.

Design

Cross-sectional analysis.

Participants

Adult non-Hispanic Black and White participants from the National Health and Nutrition Examination Survey 2001–2006.

Measures

We assessed Black-White differences in systolic blood pressure (SBP) controlling for conventional risk factors, and then additionally, for vitamin D (serum 25[OH]D).

Results

The sample included 1984 and 5156 Black and White participants ages 20 years and older. The mean age-sex adjusted Black-White SBP difference was 5.2 mm Hg. This difference was reduced to 4.0 mm Hg with additional adjustment for socio-demographic characteristics, health status, health care, health behaviors, and biomarkers; adding 25(OH)D reduced the race difference by 26% (95% CI 7–46%) to 2.9 mm Hg. This effect increased to 39% (95% CI 14–65%) when those on antihypertensive medications were excluded. Supplementary analyses that controlled for cardiovascular fitness, percent body fat, physical activity monitoring, skin type and social support yielded consistent results.

Conclusion

In cross-sectional analyses, 25(OH)D explains one quarter of the Black-White disparity in SBP. Randomized controlled trials are required to determine whether vitamin D supplementation could reduce racial disparity in BP.

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Acknowledgement

We thank Adjuah van Keken and Dawn Case for their assistance in preparation of the paper.

Funding

The National Heart Lung and Blood Institute (1R01 HL081066-01A2).

Conflict of Interest

None disclosed.

Author information

Authors and Affiliations

  1. Departments of Family Medicine and Community & Preventive Medicine, University of Rochester School of Medicine, 1381 South Ave, Rochester, NY, 14620, USA

    Kevin Fiscella MD, MPH

  2. Department of Family Medicine, University of Rochester School of Medicine, 1381 South Ave, Rochester, NY, 14620, USA

    Paul Winters MS

  3. Center for Healthcare Policy and Research, Department of Pediatrics, University of California at Davis, Sacramento, CA, USA

    Dan Tancredi PhD

  4. Center for Healthcare Policy and Research, Department of Family & Community Medicine, University of California at Davis, Sacramento, CA, USA

    Peter Franks MD

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  1. Kevin Fiscella MD, MPH
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  2. Paul Winters MS
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Correspondence to Kevin Fiscella MD, MPH.

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Fiscella, K., Winters, P., Tancredi, D. et al. Racial Disparity in Blood Pressure: is Vitamin D a Factor?. J GEN INTERN MED 26, 1105–1111 (2011). https://doi.org/10.1007/s11606-011-1707-8

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  • DOI: https://doi.org/10.1007/s11606-011-1707-8

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