Efectos del déficit de vitamina D sobre la presión arterial determinada mediante monitorización ambulatoria de 24 horas en pacientes hipertensos

Abstract

The aim off this study is assessing the possible relationship between vitamin D deficiency [25(OH)D], PTH and blood pressure levels as determined by ABPM, in addition to different target organ damage markers as well as serum markers of vascular risk in the Vascular Risk Unit of the University Hospital of Guadalajara. METHODS: This is an observational, cross-sectional study analyzing the relationship between serum levels of vitamin D [25(OH)D] and PTH with blood pressure parameters determined by ABPM, as well as the degree of target organ damage in an outpatient cohort consecutively treated in a Hypertension and Vascular Risk Unit. CONCLUSIONS: 1. Hypovitaminosis D is very prevalent in the hypertensive patients studied. Serum vitamin D levels are not associated with altered blood pressure parameters determined by ABPM or nocturnal BP reduction patterns. There is a weak association with electrocardiographic signs of left ventricular growth but not with renal damage. 2. There is a direct correlation between serum parathyroid hormone concentration, pulse pressure and blood pressure variability determined by ABPM. Likewise, there is an association between its concentration with left ventricular growth electrocardiographic parameters more robust than those found with vitamin D. 3. Patients with hyperparathyroidism secondary to vitamin D deficiency present increased blood pressure variability and reduced glomerular filtration, when compared to patients with hypovitaminosis D and normal PTH. 4. The discordance between the effects of hypovitaminosis D and that of secondary hyperparathyroidism on blood pressure assessed by ABPM, as well as on target organ damage suggest the importance of jointly evaluating the impact of both PTH and 25(OH)D levels on cardiovascular risk.