Effects of Vitamin D on Blood Pressure, Arterial Stiffness, and Cardiac Function in Older People After 1 Year: BEST‐D (Biochemical Efficacy and Safety Trial of Vitamin D)

Abstract

BackgroundThe relevance of vitamin D for prevention of cardiovascular disease is uncertain. The BEST‐D (Biochemical Efficacy and Safety Trial of vitamin D) trial previously reported effects of vitamin D on plasma markers of vitamin D status, and the present report describes the effects on blood pressure, heart rate, arterial stiffness, and cardiac function.Methods and ResultsThis was a randomized, double‐blind, placebo‐controlled trial of 305 older people living in United Kingdom, who were allocated vitamin D 4000 IU (100 μg), vitamin D 2000 IU (50 μg), or placebo daily. Primary outcomes were plasma concentrations of 25‐hydroxy‐vitamin D and secondary outcomes were blood pressure, heart rate, and arterial stiffness in all participants at 6 and 12 months, plasma N‐terminal prohormone of brain natriuretic peptide levels in all participants at 12 months, and echocardiographic measures of cardiac function in a randomly selected subset (n=177) at 12 months. Mean (SE) plasma 25‐hydroxy‐vitamin D concentrations were 50 (SE 2) nmol/L at baseline and increased to 137 (2.4), 102 (2.4), and 53 (2.4) nmol/L after 12 months in those allocated 4000 IU/d, 2000 IU/d of vitamin D, or placebo, respectively. Allocation to vitamin D had no significant effect on mean levels of blood pressure, heart rate, or arterial stiffness at either 6 or 12 months, nor on any echocardiographic measures of cardiac function, or plasma N‐terminal prohormone of brain natriuretic peptide concentration at 12 months.ConclusionsThe absence of any significant effect of vitamin D on blood pressure, arterial stiffness, or cardiac function suggests that any beneficial effects of vitamin D on cardiovascular disease are unlikely to be mediated through these mechanisms.Clinical Trial Registration URL: https://www.clinicaltrialsregister.eu/ctr-search/search. Unique identifier: EudraCT number: 2011–005763‐24a

Effect of Vitamin D Supplementation on Markers of Vascular Function: A Systematic Review and Individual Participant Meta‐Analysis

“…One further recent meta‐analysis, examining only FMD, showed a slightly greater benefit (treatment effect of vitamin D was 1.27% for FMD), perhaps attributable to differences in both study selection and the data used; our analysis had the benefit of access to IPD, which allowed us to verify the accuracy of published data and data used in previous meta‐analyses. The results are also consistent with recent data suggesting no effect of vitamin D supplementation on plasma N‐terminal pro‐B‐type natriuretic peptide levels or echocardiographic indices in older people after 12 months of therapy …”

Effects of vitamin D supplementation on 25(OH)D concentrations and blood pressure in the elderly: a systematic review and meta-analysis

“…Table 1 summarizes the characteristics of the included RCTs. The RCTs were conducted in different continents: Asia 23 , Europe 19 – 22 , 25 – 27 , America 17 , and Oceania 18 . All were placebo controlled and published in English.…”

Vitamin D – dietary intake, supplementation and metabolic status of Polish adults.

“…Al-Dujalili et al also highlighted an effect of vitamin D consumption on both systolic and diastolic blood pressure [35]. In contrast, some studies have shown no beneficial relationships in this context [36][37][38][39][40]. For example, Salekzamani et al showed that supplementation with high-dose vitamin D for 4 months was not correlated with blood pressure [41].…”