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

  • Kevin Fiscella
  • Paul Winters
  • Dan Tancredi
  • Peter Franks
Original Research

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.

KEY WORDS

vitamin D blood pressure African continental ancestry 

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Copyright information

© Society of General Internal Medicine 2011

Authors and Affiliations

  • Kevin Fiscella
    • 1
  • Paul Winters
    • 2
  • Dan Tancredi
    • 3
  • Peter Franks
    • 4
  1. 1.Departments of Family Medicine and Community & Preventive MedicineUniversity of Rochester School of MedicineRochesterUSA
  2. 2.Department of Family MedicineUniversity of Rochester School of MedicineRochesterUSA
  3. 3.Center for Healthcare Policy and Research, Department of PediatricsUniversity of California at DavisSacramentoUSA
  4. 4.Center for Healthcare Policy and Research, Department of Family & Community MedicineUniversity of California at DavisSacramentoUSA

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