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Hypertension, Vitamin D Deficiency, and Calcium Metabolism

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Endocrine Hypertension

Part of the book series: Contemporary Endocrinology ((COE))

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Abstract

Vitamin D deficiency like many other chronic diseases such as diabetes, obesity, and hypertension is increasing in prevalence. Traditionally, vitamin D was thought to be only important for its role in bone and calcium homeostasis. With the improvement of vitamin D assays including utilization of liquid chromatography tandem mass spectrometry (LC-MS/MS), measuring serum levels of 25-hydroxyvitamin D [25(OH)D] has become more reliable. The optimal serum 25(OH)D concentration for skeletal health remains to be debated and is even less certain for extra-skeletal health such as hypertension. The target serum 25(OH)D concentration may differ according to the genetic make-up/profile of each individual, which may consist of different gene polymorphisms in the vitamin D receptor and proteins involved in vitamin D metabolism. Potential mechanisms of vitamin D deficiency causing hypertension involve the renin–aldosterone–angiotensin system (RAAS) and endothelial function. As many patients with obesity also have insulin resistance, one could consider insulin resistance as a mediator in causing elevated blood pressure. Based on data from cross-sectional and cohort studies, vitamin D deficiency increases the risk of incident hypertension. Although more definitive trials have not yet been completed to examine the role of vitamin D in hypertension, it seems prudent to recommend that patients with vitamin D deficiency be encouraged to modify their lifestyles and take vitamin D supplementation to achieve serum 25(OH)D concentrations that are optimal for skeletal health (at least 30 ng/mL). The completion of randomized controlled trials will inform whether vitamin D can influence the onset of hypertension and/or reduce blood pressure in individuals with established hypertension.

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Authors and Affiliations

  1. Division of Internal Medicine and Hypertension, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS, 39216, USA

    M. Iftekhar Ullah

  2. Division of Endocrinology, University of Mississippi Medical Center, Jackson, MS, USA

    Christian A. Koch

  3. Section of Endocrinology, Division of Endocrinology, Diabetes & Lipids, Emory University School of Medicine, Atlanta VA Medical Center, Atlanta, GA, USA

    Vin Tangpricha

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Correspondence to M. Iftekhar Ullah .

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  1. Dept. Medicine, Div. Endocrinology, Diabetes &, University of Mississippi Medical Center, N. State Street 2500, Jackson, 39216, Mississippi, USA

    Christian A Koch

  2. UNESCO Chair on Adolescent Health Care, Division of Endocrinology, University of Athens Medical School, Aghia Sophia Children's Hospital, Athens, 11527, Greece

    George P Chrousos

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Ullah, M.I., Koch, C.A., Tangpricha, V. (2013). Hypertension, Vitamin D Deficiency, and Calcium Metabolism. In: Koch, C., Chrousos, G. (eds) Endocrine Hypertension. Contemporary Endocrinology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-548-4_10

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