Associations of 25-Hydroxyvitamin D With the Blood Pressure Response to Maximal Exercise Among Healthy Adults.

Insufficient 25-hydroxyvitamin D [25(OH)D] levels are associated with high resting blood pressure (BP). However, the relationship between 25(OH)D and the peak systolic BP (SBP) response to exercise, a predictor of future hypertension, has yet to be investigated. We sought to examine the relationship among serum 25(OH)D and the peak SBP response to a graded exercise stress test (GEST) among a large sample (n = 417) of healthy men (49%) and women (51%) over a broad age range (20-76 years; mean age: 44.1 ± 0.8 years). We hypothesized that individuals with clinically insufficient 25(OH)D would have a greater peak SBP response to a GEST compared to individuals with sufficient 25(OH)D levels. Fasting serum 25(OH)D, anthropometrics, resting BP, and peak exercise SBP were obtained at the baseline visit of a larger clinical trial (STOMP; NCT01140308). Mean 25(OH)D levels were 36.1 ± 0.7 ng/ml, with ∼35% of individuals classified as insufficient (<30 ng/ml). Average resting BP was 119 ± 13 mmHg/75 ± 10 mmHg, with 52.3% considered to have normal BP, while 25.2% had elevated BP and 22.5% had established hypertension. The peak SBP response to a GEST was similar between individuals with sufficient (48 ± 19 mmHg) versus insufficient (48 ± 18 mmHg) 25(OH)D (p = 1.000). One unexpected finding emerged such that individuals with sufficient 25(OH)D had higher resting SBP (120 ± 14 mmHg vs. 117 ± 13 mmHg; p = .020) than individuals with insufficient 25(OH)D. In contrast to our hypothesis, 25(OH)D levels were not associated with the peak SBP response to a GEST. Baseline 25(OH)D levels were positively correlated with resting SBP; however, the magnitude of this effect is likely not clinically meaningful.

[1]  Wilbert S Aronow,et al.  2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. , 2018, Hypertension.

[2]  Daniel W. Jones,et al.  Potential US Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline , 2018, Circulation.

[3]  A. Quyyumi,et al.  Vitamin D and Cardiovascular Disease: Controversy Unresolved. , 2017, Journal of the American College of Cardiology.

[4]  C. Annweiler,et al.  Vitamin D and cardiovascular disease: From atherosclerosis to myocardial infarction and stroke. , 2017, International journal of cardiology.

[5]  J. Ha,et al.  Hypertensive response to exercise: mechanisms and clinical implication , 2016, Clinical Hypertension.

[6]  İ. Barutçu,et al.  Assessment of 25-OH vitamin D levels and abnormal blood pressure response in female patients with cardiac syndrome X , 2016, Anatolian journal of cardiology.

[7]  C Noel Bairey Merz,et al.  Coronary Microvascular Dysfunction　- Epidemiology, Pathogenesis, Prognosis, Diagnosis, Risk Factors and Therapy. , 2016, Circulation journal : official journal of the Japanese Circulation Society.

[8]  Thomas J. Wang,et al.  High-Dose versus Low-Dose Vitamin D Supplementation and Arterial Stiffness among Individuals with Prehypertension and Vitamin D Deficiency , 2015, Disease markers.

[9]  K. Bennett,et al.  The effect of vitamin D supplementation on arterial stiffness in an elderly community-based population. , 2015, Journal of the American Society of Hypertension : JASH.

[10]  D. Gardner,et al.  Elimination of Vitamin D Receptor in Vascular Endothelial Cells Alters Vascular Function , 2014, Hypertension.

[11]  T. Münzel,et al.  Is at least one vitamin helping our vasculature? Evidence for an important role of the endothelial vitamin d receptor in regulating endothelial function and blood pressure. , 2014, HYPERTENSION.

[12]  M. Rocco,et al.  25-Hydroxyvitamin D testing and supplementation in CKD: an NKF-KDOQI controversies report. , 2014, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[13]  P. Thompson,et al.  Effect of Statins on Skeletal Muscle Function , 2012, Circulation.

[14]  R. Vieth.  Why the minimum desirable serum 25-hydroxyvitamin D level should be 75 nmol/L (30 ng/ml). , 2011, Best practice & research. Clinical endocrinology & metabolism.

[15]  A. Quyyumi,et al.  Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans. , 2011, Journal of the American College of Cardiology.

[16]  S. Larsson,et al.  Blood 25-hydroxyvitamin D concentration and hypertension: a meta-analysis , 2011, Journal of hypertension.

[17]  M. Razzaque,et al.  The dualistic role of vitamin D in vascular calcifications. , 2011, Kidney international.

[18]  Christine L. Taylor,et al.  Committee to Review Dietary Reference Intakes for Vitamin D and Calcium , 2011 .

[19]  K. Forrest,et al.  Prevalence and correlates of vitamin D deficiency in US adults. , 2011, Nutrition research.

[20]  E. Hoffman,et al.  A randomized clinical trial to assess the effect of statins on skeletal muscle function and performance: rationale and study design. , 2010, Preventive cardiology.

[21]  S. Boonen,et al.  IOF position statement: vitamin D recommendations for older adults , 2010, Osteoporosis International.

[22]  D. Levy,et al.  Exercise blood pressure and the risk of incident cardiovascular disease (from the Framingham Heart Study). , 2008, The American journal of cardiology.

[23]  M. Holick.  Vitamin D deficiency. , 2007, The New England journal of medicine.

[24]  Keith C. Norris,et al.  Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. , 2007, Archives of internal medicine.

[25]  Edward Giovannucci,et al.  Plasma 25-Hydroxyvitamin D Levels and Risk of Incident Hypertension , 2007, Hypertension.

[26]  P. Thompson,et al.  Peak systolic blood pressure on a graded maximal exercise test and the blood pressure response to an acute bout of submaximal exercise. , 2006, The American journal of cardiology.

[27]  P. Lips,et al.  Estimates of optimal vitamin D status , 2005, Osteoporosis International.

[28]  E. Howley,et al.  Criteria for maximal oxygen uptake: review and commentary. , 1995, Medicine and science in sports and exercise.

[29]  P Froom,et al.  Blood pressure response to exercise as a predictor of hypertension. , 1986, Archives of internal medicine.