Vitamin D, parathyroid hormone and cardiovascular risk

Abstract

25-Hydroxyvitamin D insufficiency and increased cardiovascular risk (CVR) association is still debated. The vitamin D (VitD)-dependent parathyroid hormone (PTH) is considered as the possible actuator of VitD effects on CVR. To investigate the association of CVR, PTH and VitD, we carried out blood pressure measurements and blood samples and collected information on dietary habits, anamnestic, clinical and metabolic data of 451 participants in the Salerno area (Southern Italy) during the World Hypertension Day (17 May). CVR was calculated according to the Framingham CVR charts. The overall population mean age was 51.6 ± 0.7 years, and female sex was slightly prevalent (55%). VitD deficiency (<20 ng/ml) was most frequent (59.7%). In this population, VitD and CVR did not correlate. VitD and PTH inversely correlated (r = −0.265, P < 0.001) as expected. PTH was in direct correlation (r = 0.225, P < 0.001) with CVR. Elevated PTH (75 percentile; ≥49.5 pg/ml) levels identify a population with higher CVR (11.8 ± 0.5 vs. 8.5 ± 0.3, P < 0.001). In a multivariate analysis, both age and PTH correlate to CVR, but not VitD. In conclusion, VitD does not directly affect CVR in the overall population. Rather, increased PTH might be a better predictor of CVR.

We are What We Eat: Impact of Food from Short Supply Chain on Metabolic Syndrome

“…On the occasion of 2015-2017 World Hypertension Day (May 17th), booths were organized in the major squares of the mentioned villages, harnessing a collaborative effort of the Medical School of Salerno and local authorities [15]. The event was successfully publicized with a 15-day notice via local media advertisements, and we had the partnership of local authorities and patient associations, as well as parishes.…”

The Antioxidant Therapy: New Insights in the Treatment of Hypertension

“…The vascular effects of such hormone, as well as the mechanisms associated with the reduced kidney function are both possible mechanisms of increased vascular resistance and blood volume, two determinants of hypertension. Indeed, increased PTH has been demonstrated to correlates better than Vitamin D deficiency with blood pressure and cardiovascular risk, including hypertension, in a large population in Southern Italy (Pascale et al, 2018 ) suggesting that also PTH levels could be a discriminating parameter in the selection of patients that could be sensitive to Vitamin D supplementation. Thus, future researches on this issue should take into account these parameters and, accordingly, identify an ideal population which result more sensitive to this kind of treatment.…”

Should We Consider the Cardiovascular System While Evaluating CKD-MBD?

“…In addition, PTH may stimulate the vascular smooth muscle cells to produce factors including collagen and beta-1 integrin which could, in turn, remodel the peripheral vasculature. Another potential effect of PTH would be the increase of renin release and activation of the renin-angiotensin system, a process mediated by serum calcium and renal 1-alpha hydroxylase [69]. Aman et al have underlined the effect of PTH as the major determining factor of coronary artery lesions, ranging from the discontinuity of the elastic lamina to the calcification of the medial layer, confirming the agreeable action of PTH [70].…”

“…It was reported that PTH increases with age, weight, BMI, SBP, and LDL, all risk factors for CVD. Increased SBP would be a hemodynamic effect of PTH on cardiac remodeling [68,69]. Evidence suggests that PTH has vascular effects [68].…”