Nutritional Endocrinology

Circulating 25-hydroxyvitamin D levels in relation to blood pressure parameters and hypertension in the Shanghai Women's and Men's Health Studies

Tsogzolmaa Dorjgochoo^a1, Xiao Ou Shu^a1 c1, Yong-Bing Xiang^a2, Gong Yang^a1, Qiuyin Cai^a1, Honglan Li^a2, Bu-Tian Ji^a3, Hui Cai^a1, Yu-Tang Gao^a2 and Wei Zheng^a1

^a1 Division of Epidemiology, Department of Medicine and Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, 2525 West End Avenue, Suite 600, IMPH, Nashville, TN 37203, USA

^a2 Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, People's Republic of China

^a3 Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA

Abstract

Little is known about the association of circulating 25-hydroxyvitamin D (25(OH)D) and blood pressure (BP) parameters, including systolic and diastolic BP, pulse pressure (PP), mean arterial pressure (MAP) and hypertension in non-Western populations that have not yet been exposed to foods fortified with vitamins and seldom use vitamin D supplements. A cross-sectional analysis of plasma 25(OH)D levels in association with BP measures was performed for 1460 participants (1055 women and 405 men, aged 40–74 years) of two large cohort studies in Shanghai. Multivariable linear and logistic regressions were conducted. Overall, the prevalence of vitamin D deficiency was 55·8 % using National Health and Nutrition Examination Survey, USA criteria and 29·9 % using WHO criteria. The median plasma 25(OH)D level in the population was 38·0 nmol/l for men and 33·6 nmol/l for women (P < 0·01) among participants who were not on antihypertensive drugs. Among men, BP parameters (systolic BP, diastolic BP and MAP) were significantly and inversely associated with higher quintiles of 25(OH)D compared with the lowest quintile (P _trend < 0·05 for all). Vitamin D non-deficient status (WHO criteria) was inversely associated with hypertension (OR_adjusted = 0·29; 95 % CI 0·10, 0·82). An inverse association was also found between hypertension and the highest quintile of 25(OH)D (OR_adjusted = 0·16; 95 % CI 0·04, 0·65 for ≥ 50·6 nmol/l; P _trend = 0·02). Among women, no significant associations were found for BP parameters and hypertension. The present study shows that vitamin D deficiency is common among adults in urban China. Circulating 25(OH)D levels were inversely related to the levels of individual BP parameters and hypertension among middle-aged and elderly men but not among women. More research is needed to investigate the potential sex differential associations.

(Received January 10 2011)

(Revised September 14 2011)

(Accepted September 25 2011)

(Online publication February 27 2012)

Key Words:

• Blood pressure parameters;
• Hypertension;
• 25-Hydroxyvitamin D;
• Sex differences;
• China

Correspondence:

^c1 Corresponding author: Dr X. O. Shu, fax +1 615 936 8291, email xiao-ou.shu@vanderbilt.edu

Footnotes

Abbreviations: 1,25(OH)2D, 1,25 dihydroxy vitamin D; 25(OH)D, 25-hydroxyvitamin D; BP, blood pressure; MAP, mean arterial pressure; MET, metabolic equivalents; NHANES, National Health and Nutrition Examination Survey; PP, pulse pressure; PTH, parathyroid hormone; SMHS, Shanghai Men's Health Study; SWHS, Shanghai Women's Health Study; VDPP, Vitamin D Pooling Project