Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial
Witham MD, Price RJ, Struthers AD, Donnan PT, Messow CM, Ford I, McMurdo ME
JAMA internal medicine · 122 citas
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- Chief Scientist Office
Según 1 financiador declarado.
Publicación
- Publicado
- 2013-08-12 · JAMA Intern Med · vol. 173 · número 18 · págs. 1672–9
- Editorial
- American Medical Association
- Citado
- 145 citas · más que el 99% de estudios similares · 15.3× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 50 trabajos
- Acceso
- De pago
- Áreas de investigación
- Vitamin D Research Studies · Blood Pressure and Hypertension Studies · Parathyroid Disorders and Treatments
- Palabras clave
- vitamin D3, vitamin D supplementation, isolated systolic hypertension, older adults, blood pressure reduction, 25-hydroxyvitamin D, arterial stiffness, endothelial function, falls, insulin resistance, brain natriuretic peptide, cholesterol, falls in older adults
- MeSH
- humans, hypertension, cholecalciferol, vitamins, treatment outcome, follow-up studies, prospective studies, double-blind method, blood pressure, systole, dose-response relationship, drug, dietary supplements, aged
7 autores
- Miles D. Witham🇬🇧University of Dundee
- Rosemary J. G. Price🇬🇧University of Dundee
- Allan D. Struthers🇬🇧University of Dundee
- Peter T. Donnan🇬🇧University of Dundee
- Claudia‐Martina Messow🇬🇧University of Glasgow
- Ian Ford🇬🇧University of Glasgow
- Marion E. T. McMurdo🇬🇧University of Dundee
Resumen
El texto original del estudio, en el idioma en que se publicó.
Importance
Observational data link low 25-hydroxyvitamin D levels to both prevalent blood pressure and incident hypertension. No clinical trial has yet examined the effect of vitamin D supplementation in isolated systolic hypertension, the most common pattern of hypertension in older people.
Objective
To test whether high-dose, intermittent cholecalciferol supplementation lowers blood pressure in older patients with isolated systolic hypertension.
Design
Parallel group, double-blind, placebo-controlled randomized trial.
Setting
Primary care clinics and hospital clinics.
Participants
Patients 70 years and older with isolated systolic hypertension (supine systolic blood pressure >140 mm Hg and supine diastolic blood pressure <90 mm Hg) and baseline 25-hydroxyvitamin D levels less than 30 ng/mL were randomized into the trial from June 1, 2009, through May 31, 2011.
Interventions
A total of 100,000 U of oral cholecalciferol or matching placebo every 3 months for 1 year.
Main outcomes and measures
Difference in office blood pressure, 24-hour blood pressure, arterial stiffness, endothelial function, cholesterol level, insulin resistance, and b-type natriuretic peptide level during 12 months.
Results
A total of 159 participants were randomized (mean age, 77 years). Mean baseline office systolic blood pressure was 163/78 mm Hg. Mean baseline 25-hydroxyvitamin D level was 18 ng/mL. 25-Hydroxyvitamin D levels increased in the treatment group compared with the placebo group (+8 ng/mL at 1 year, P < .001). No significant treatment effect was seen for mean (95% CI) office blood pressure (−1 [−6 to 4]/−2 [−4 to 1] mm Hg at 3 months and 1 [−2 to 4]/0 [−2 to 2] mm Hg overall treatment effect). No significant treatment effect was evident for any of the secondary outcomes (24-hour blood pressure, arterial stiffness, endothelial function, cholesterol level, glucose level, and walking distance). There was no excess of adverse events in the treatment group, and the total number of falls was nonsignificantly lower in the group receiving vitamin D (36 vs 46, P = .24).
Conclusions and relevance
Vitamin D supplementation did not improve blood pressure or markers of vascular health in older patients with isolated systolic hypertension.
Trial registration
isrctn.org Identifier: ISRCTN92186858.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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