Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey

R Scragg, MF Sowers, C Bell - American journal of hypertension, 2007 - academic.oup.com
R Scragg, MF Sowers, C Bell
American journal of hypertension, 2007academic.oup.com
Background: Populations with low vitamin D status, such as blacks living in the US or UK,
have increased blood pressure (BP) compared with whites. We analyzed the association
between serum 25-hydroxyvitamin D (25OHD) and BP to determine whether low 25OHD
explains any of the increased BP in blacks. Methods: The Third US National Health and
Nutrition Examination Survey (NHANES III) is a cross-sectional survey representative of the
US civilian population during 1988 to 1994. Analyses were restricted to 12,644 people …
Background
Populations with low vitamin D status, such as blacks living in the US or UK, have increased blood pressure (BP) compared with whites. We analyzed the association between serum 25-hydroxyvitamin D (25OHD) and BP to determine whether low 25OHD explains any of the increased BP in blacks.
Methods
The Third US National Health and Nutrition Examination Survey (NHANES III) is a cross-sectional survey representative of the US civilian population during 1988 to 1994. Analyses were restricted to 12,644 people aged ≥20 years with measurements of BP and 25OHD, after excluding those on hypertensive medication.
Results
Adjusted mean serum 25OHD was lowest in non-Hispanic blacks (49 nmol/L), intermediate in Mexican Americans (68 nmol/L), and highest in non-Hispanic whites (79 nmol/L). When participants were divided into 25OHD quintiles, mean (standard error) systolic BP was 3.0 (0.7) mm Hg lower (P = .0004) and diastolic BP was 1.6 (0.6) mm Hg lower (P = .011) for participants in the highest quintile (25OHD ≥85.7 nmol/L) compared with the lowest (25OHD ≤40.4 nmol/L), adjusting for age, sex, ethnicity, and physical activity. Further adjustment for body mass index (BMI) weakened the inverse association between 25OHD and BP, which remained significant for systolic BP (P < .05). The inverse association between 25OHD and systolic BP was stronger in participants aged ≥50 years than younger (P = .021). Ethnic differences in 25OHD explained about half of the increased hypertension prevalence in non-Hispanic blacks compared with whites.
Conclusions
Vitamin D status, which is amenable to intervention by safely increasing sun exposure or vitamin D supplementation, was associated inversely with BP in a large sample representative of the US population. Am J Hypertens 2007;20: 713–719 © 2007 American Journal of Hypertension, Ltd.
Oxford University Press
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