Relationship of vitamin D and parathyroid hormone with the nocturnal blood pressure decline in hypertension.
Blood Press Monit. 2017 Sep 18. doi: 10.1097/MBP.0000000000000286. [Epub ahead of print]
Karadag MK1, Secen O. Cardiology Clinic, Elazig Education and Research Hospital, U. of Health Sciences, Elazig, Turkey.
Summary of study
| Vitamin D | PTH | |
| Hypertension - nondipper | 9.7 | 75 |
| Hypertension dipper | 14.8 | 53 |
| No Hypertension | 16.4 |
nondipping described in another PubMed publication
- "Normal dipping pattern is characterized by a >10% dip in the BP during the night. Nondipping pattern is associated with severity of the disease, target organ damage, secondary forms of hypertension, multiple cardiovascular risk factors, and poor long-term outcomes."
- Hypertension and vitamin D has: "Blood pressures not dropping at night associated with very low level of vitamin D – May 2012"
From the web
OBJECTIVES:
Vitamin D deficiency and high parathyroid hormone (PTH) levels have been linked with hypertension.
Nondipper hypertension is associated with increased morbidity and mortality.
We aimed to investigate the relationship of vitamin D and PTH levels with nondipper hypertension and nocturnal decline in untreated hypertensive patients.
PATIENTS AND METHODS:
This cross-sectional study included a total of 73 hypertensive and 34 normotensive participants. Each patient underwent 24-hour ambulatory blood pressure monitoring, routine biochemical tests, vitamin D, and PTH analysis.
RESULTS:
The study population was divided into three groups according to ambulatory blood pressure monitoring records: 40 nondippers (mean age; 59.8±10.8 years, 24 women and 16 men), 33 dipper hypertensives (mean age; 58±11.8 years, 13 women and 20 men), and 34 normotensives (mean age; 56.9±11.7 years, 19 women and 15 men).
Nondipper hypertensives showed lower levels of vitamin D than dippers and normotensives (9.7±6.1 vs. 14.9±10.1 vs. 16.4±9.5 ng/ml, P=0.001, for both) and higher levels of PTH than dippers (74.8±34.7 vs. 53.3±19.9 ng/ml, P=0.001). A significant positive correlation was observed between vitamin D and nocturnal decline (r=0.34, P=0.001), whereas a significant negative correlation was present between PTH and nocturnal decline(r=-0.26, P=0.006). In multivariate analysis, PTH level was correlated independently with nocturnal decline (β=-0.07, 95% confidence interval: -0.114-0.025, P=0.003).
CONCLUSION:
In this study, vitamin D levels were significantly lower and PTH levels were significantly higher in nondippers. The vitamin D level was correlated positively and the PTH level was correlated negatively with nocturnal decline. In addition, PTH level was associated independently with nocturnal decline in hypertension.
PMID: 28926360 DOI: 10.1097/MBP.0000000000000286 PDF is behind a publisher paywall