Effects of Vitamin D and Calcium Supplementation on Heart Rate and Blood Pressure in Community-Dwelling Older Individuals

Chapter

Abstract

Objectives: Vitamin D deficiency has been linked to hypertension and ­cardiovascular events in observational studies. It is unclear whether vitamin D and/or calcium supplementation can reduce blood pressure, and if so, by how much.

Methods: This prospective study was undertaken to test the influence of latitude, seasonal variations, possible threshold effects, and duration of vitamin D efficacy after cessation of therapy. Two hundred and forty-two healthy male and female subjects with a mean age of 77 ± 4 years and a 25-hydroxyvitamin D serum level below 75 nmol/l were recruited in Bad Pyrmont and Graz and were randomly assigned to two treatment groups: one group receiving 1,000 mg calcium per day (Ca) and the other group 1,000 mg calcium and 800 IU vitamin D (Ca + D) over 12 months. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were measured under standardized conditions every 4 months. Statistical evaluation was carried out using the statistics software of IDV, Gauting (Test + Estimation, version 5.2, “CRO” Dr. Heinz and Partner, Vienna, Austria).

Results: We performed an intention-to-treat analysis and found the following results:
  • In the (Ca + D) group, 25-hydroxyvitamin D increased significantly (p < 0.01) from 57 ± 20 nmol/l at baseline (BL) to 84 ± 18 nmol/l at month 12 (M12), whereas in the (Ca) group, there was no change (54 ± 19 versus 55 ± 18 nmol/l).

  • In the (Ca + D) group, SBP decreased significantly (p < 0.01) from 134 ± 17 mmHg at BL to 124 ± 14 mmHg at M12, whereas in the (Ca) group, there was no change (137 ± 17 versus 133 ± 16 mmHg).

  • In the (Ca + D) group, DBP decreased significantly (p < 0.01) from 76 ± 7 mmHg at BL to 72 ± 7 mmHg at M12, whereas in the (Ca) group, there was no change (79 ± 8 versus 78 ± 9 mmHg).

  • In the (Ca + D) group, HR decreased significantly (p < 0.01) from 74 ± 4 beats per minute at BL to 70 ± 4 beats per minute at M12, whereas in the (Ca) group, there was no change (74 ± 4 versus 75 ± 4 beats per minute).

Conclusion: Despite a relatively high inclusion criterion for vitamin D (75 nmol/l) and independent of latitude, we observed a significant reduction of blood pressure and heart rate after supplementation with vitamin D and calcium. This effect of nutritional supplements may be comparable to the efficiency of antihypertensive drugs.

Keywords

Vitamin D deficiency Heart rate Blood pressure Calcium and vitamin D supplementation Randomized controlled trial (RCT) 

References

  1. 1.
    Hypponen E, Power C. Hypovitaminosis in British adults at age 45 years: nationwide cohort study of dietary and lifestyle predictors. Am J Clin Nutr. 2007;85:860–8.PubMedGoogle Scholar
  2. 2.
    Scragg R, Sowers M, Bell C. Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination. Am J Hypertens. 2007;20:713–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Pfeifer M, Begerow B, Minne HW. Vitamin D and muscle function. Osteoporos Int. 2002;13:187–94.PubMedCrossRefGoogle Scholar
  4. 4.
    Forman JP, Giovannucci E, Holmes MD, Bischoff-Ferrari HA, Tworogger SS, Willett WC, Curhan GC. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension. 2007;49:1063–9.PubMedCrossRefGoogle Scholar
  5. 5.
    Schleithoff SS, Zitterman A, Tenderich G, Berthold HK, Stehle P, Koerfer R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. Am J Clin Nutr. 2006;83:754–9.PubMedGoogle Scholar
  6. 6.
    Langford HG, Nainby-Luxemoore JC, Melson JC, et al. Hyperparathyroidism is associated with hypertension and may be causal. Clin Res. 1980;28:333–8.Google Scholar
  7. 7.
    Bogin E, Massry SC, Levi J, et al. Effect of parathyroid hormone on osmotic fragility of human erythrocytes. J Clin Invest. 1982;69:1017–25.PubMedCrossRefGoogle Scholar
  8. 8.
    Stefenelli T, Mayr H, Bergler-Klein J, et al. Primary hyperparathyroidism: incidence of cardiac abnormalities and partial reversibility after successful parathyroidectomy. Am J Med. 1993;95:197–202.PubMedCrossRefGoogle Scholar
  9. 9.
    Hulter HN, Melby JC, Petersen JC, Cooke CR. Chronic continuous PTH infusion results in hypertension in normal subjects. J Clin Hypertens. 1986;4:360–70.Google Scholar
  10. 10.
    Melamed ML, Michos ED, Post W, Astor B. 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med. 2008;168:1629–37.PubMedCrossRefGoogle Scholar
  11. 11.
    Dobnig H, Pilz S, Scharnagl H, Renner W, Seelhorst U, Wellnitz B. Independent association of low serum 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D with all-cause and cardiovascular mortality. Arch Intern Med. 2008;168:1340–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K. Vitamin D deficiency and risk of cardiovascular disease. Circulation. 2008;117:503–12.PubMedCrossRefGoogle Scholar
  13. 13.
    Autier P, Gandini S. Vitamin D supplementation and total mortality: a meta-analysis of randomized controlled trials. Arch Intern Med. 2007;167:1730–7.PubMedCrossRefGoogle Scholar
  14. 14.
    Witham MD, Nadir MA, Struthers AD. Effect of vitamin D on blood pressure: a systemic review and meta-analysis. J Hypertens. 2009;27:1948–54.PubMedCrossRefGoogle Scholar
  15. 15.
    Pittas AG, Chung M, Trikalinos T, et al. Vitamin D and cardiometabolic outcomes: a systematic review. Ann Intern Med. 2010;152:307–14.PubMedGoogle Scholar
  16. 16.
    Pfeifer M, Begerow B, Minne HW, Nachtigall D, Hansen C. Effects of a short-term vitamin D and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab. 2001;86:1633–7.PubMedCrossRefGoogle Scholar
  17. 17.
    Pfeifer M, Begerow B, Minne HW, Suppan K, Fahrleitner-Pammer A, Dobnig H. Effects of a long-term vitamin D and calcium supplementation on falls and other parameters of muscle function in community-dwelling older individuals. Osteoporos Int. 2009;20:315–22.PubMedCrossRefGoogle Scholar
  18. 18.
    Bischoff-Ferrari HA, Willett WC, Orav EJ, et al. A pooled analysis of vitamin D dose requirements for fracture prevention. N Engl J Med. 2012;367:40–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Hsia J, Heiss G, Ren H, et al. Calcium/vitamin D supplementation and cardiovascular events. Circulation. 2007;115:846–54.PubMedCrossRefGoogle Scholar
  20. 20.
    Forman JP, Giovannucci E, Holmes MD, et al. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension. 2007;49:1063–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Forman JP, Curhan GC, Taylor EN. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension among young women. Hypertension. 2008;52:828–32.PubMedCrossRefGoogle Scholar
  22. 22.
    Wang L, Manson JE, Buring JE, Lee IM, Sesso HD. Dietary intake of dairy products, calcium, and vitamin D and the risk of hypertension in middle-aged and older women. Hypertension. 2008;51:1073–9.PubMedCrossRefGoogle Scholar
  23. 23.
    Giovannucci E, Liu Y, Hollis BW, Rimm EB. 25-hydroxyvitamin D and risk of myocardial infarction in men: a prospective study. Arch Intern Med. 2008;168:1174–80.PubMedCrossRefGoogle Scholar
  24. 24.
    Pilz S, Dobnig H, Fischer JE, et al. Low vitamin D levels predict stroke in patients referred to coronary angiography. Stroke. 2008;39:2611–3.PubMedCrossRefGoogle Scholar
  25. 25.
    Marniemi J, Alanen E, Impivaara O, et al. Dietary and serum vitamins and minerals as predictors of myocardial infarction and stroke in elderly subjects. Nutr Metab Cardiovasc Dis. 2005;15:188–97.PubMedCrossRefGoogle Scholar
  26. 26.
    Scragg R, Khaw KT, Murphy S. Effects of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr. 1995;49:640–6.PubMedGoogle Scholar
  27. 27.
    Krause R, Buhring M, Hopfenmüller W, Holick MF, Sharma AM. Ultraviolet B and blood pressure. Lancet. 1998;352:709–10.PubMedCrossRefGoogle Scholar
  28. 28.
    Margolis KL, Ray RM, Van Horn L, et al. Effect of calcium and vitamin D supplementation on blood pressure: the Women’s Health Initiative Randomized Trial. Hypertension. 2008;52:847–55.PubMedCrossRefGoogle Scholar
  29. 29.
    Nemerovski CW, Dorsch MP, Simpson RU, Bone HG, Aaronson KD, Bleske BE. Vitamin D and cardiovascular disease. Pharmacotherapy. 2009;29:691–708.PubMedCrossRefGoogle Scholar
  30. 30.
    Prentice A, Goldberg GR, Schoenmakers I. Vitamin D across the lifecycle: physiology and biomarkers. Am J Clin Nutr. 2008;88:500S–6.PubMedGoogle Scholar
  31. 31.
    Jacobs DR, Steffen LM. Nutrients, foods and dietary patterns as exposures in research: a framework for food synergy. Am J Clin Nutr. 2003;78:508S–13.PubMedGoogle Scholar
  32. 32.
    Bischoff-Ferrari HA, Giovannucci E, Willett WC, Dietrich T, Dawson-Hughes B. Estimation of optimal serum concentrations of serum 25-hydroxyvitamin D for multiple health outcomes. Am J Clin Nutr. 2006;84:18–28.PubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Institute of Clincal Osteology Bad Pyrmont and German Osteology FoundationBad Pyrmont, Lower SaxonyGermany

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