Effect of Vitamin D Supplementation on Blood Pressure: A Systematic Review and Meta-analysis Incorporating Individual Patient Data
Beveridge LA, Struthers AD, Khan F, Jorde R, Scragg R, Macdonald HM, Alvarez JA, Boxer RS, Dalbeni A, Gepner AD, Isbel NM, Larsen T, Nagpal J, Petchey WG, Stricker H, Strobel F, Tangpricha V, Toxqui L, Vaquero MP, Wamberg L, Zittermann A, Witham MD, D-PRESSURE Collaboration
JAMA internal medicine · 225 citas
Cómo se estudió
- Diseño
- Revisión sistemática (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
- Gobierno
- U.S. Department of Veterans Affairs
- Gobierno
- National Institute on Aging
- Gobierno
- National Institute of Diabetes and Digestive and Kidney Diseases
- Gobierno
- National Center for Research Resources
- Gobierno
- NIDDK NIH HHS
- Gobierno
- NCRR NIH HHS
- Gobierno
- Chief Scientist Office
- Subvenciones
- National Institute on Aging (R21 AG053413); National Center for Research Resources (K12RR023264); National Institute of Diabetes and Digestive and Kidney Diseases (K01DK102851); National Institute of Diabetes and Digestive and Kidney Diseases (L30 DK106709); U.S. Department of Veterans Affairs (I21 CX001340); National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007298)
Según 7 financiadores declarados.
Publicación
- Publicado
- 2015-03-16 · JAMA Intern Med · vol. 175 · número 5 · pág. 745
- Editorial
- American Medical Association
- Citado
- 309 citas · más que el 100% de estudios similares · 35.6× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 83 trabajos
- Acceso
- Acceso abierto (copia en repositorio) · OTHER-OA
- Áreas de investigación
- Vitamin D Research Studies · Blood Pressure and Hypertension Studies · Parathyroid Disorders and Treatments
- Palabras clave
- vitamin D supplementation, blood pressure, vitamin D analogs, 25-hydroxyvitamin D, systolic blood pressure, diastolic blood pressure, hypertension, cardiovascular risk, predictors of treatment response, vitamin D deficiency, calcium supplementation, magnesium supplementation, dietary fat supplementation, vitamin C supplementation, vitamin B12 supplementation
- MeSH
- humans, hypertension, vitamins, vitamin d, treatment failure, biological availability, blood pressure
22 autores
- Louise A Beveridge🇬🇧University of Dundee; Ninewells Hospital
- Allan D. Struthers🇬🇧University of Dundee; Ninewells Hospital
- Faisel Khan🇬🇧University of Dundee; Ninewells Hospital
- Rolf Jorde🇳🇴UiT The Arctic University of Norway
- Robert K.R. Scragg🇳🇿University of Auckland
- Helen M. Macdonald🇬🇧University of Aberdeen
- Jessica A. Alvarez🇺🇸Emory University
- Rebecca S. Boxer🇺🇸University of Colorado Anschutz; University of Colorado Denver
- Andrea Dalbeni🇮🇹University of Verona
- Adam D. Gepner🇺🇸University of Wisconsin–Madison
- Nicole M. Isbel🇦🇺Princess Alexandra Hospital
- Thomas Larsen🇩🇰Regional Hospital Holstebro
- Jitender Nagpal🇮🇳Sitaram Bhartia Institute of Science and Research
- William G. Petchey🇬🇧National Health Service; Cambridge University Hospitals NHS Foundation Trust
- Hans J. Stricker🇨🇭Ospedale Regionale di Locarno
- Franziska Strobel🇩🇪Asklepios
- Vin Tangpricha🇺🇸Emory University
- Laura Toxqui🇪🇸Consejo Superior de Investigaciones Científicas; Instituto de Ciencia y Tecnología de Alimentos y Nutrición
- María Pilar Vaquero🇪🇸Consejo Superior de Investigaciones Científicas; Instituto de Ciencia y Tecnología de Alimentos y Nutrición
- Louise Wamberg🇩🇰Aarhus University Hospital
- Armin Zittermann🇩🇪Heart and Diabetes Center North Rhine-Westphalia; Ruhr University Bochum
- Miles D. Witham🇬🇧University of Dundee; Ninewells Hospital
Resumen
El texto original del estudio, en el idioma en que se publicó.
Importance
Low levels of vitamin D are associated with elevated blood pressure (BP) and future cardiovascular events. Whether vitamin D supplementation reduces BP and which patient characteristics predict a response remain unclear.
Objective
To systematically review whether supplementation with vitamin D or its analogues reduce BP.
Data sources
We searched MEDLINE, CINAHL, EMBASE, Cochrane Central Register of Controlled Trials, and http://www.ClinicalTrials.com augmented by a hand search of references from the included articles and previous reviews. Google was searched for gray literature (ie, material not published in recognized scientific journals). No language restrictions were applied. The search period spanned January 1, 1966, through March 31, 2014.
Study selection
We included randomized placebo-controlled clinical trials that used vitamin D supplementation for a minimum of 4 weeks for any indication and reported BP data. Studies were included if they used active or inactive forms of vitamin D or vitamin D analogues. Cointerventions were permitted if identical in all treatment arms.
Data extraction and synthesis
We extracted data on baseline demographics, 25-hydroxyvitamin D levels, systolic and diastolic BP (SBP and DBP), and change in BP from baseline to the final follow-up. Individual patient data on age, sex, medication use, diabetes mellitus, baseline and follow-up BP, and 25-hydroxyvitamin D levels were requested from the authors of the included studies. For trial-level data, between-group differences in BP change were combined in a random-effects model. For individual patient data, between-group differences in BP at the final follow up, adjusted for baseline BP, were calculated before combining in a random-effects model.
Main outcomes and measures
Difference in SBP and DBP measured in an office setting.
Results
We included 46 trials (4541 participants) in the trial-level meta-analysis. Individual patient data were obtained for 27 trials (3092 participants). At the trial level, no effect of vitamin D supplementation was seen on SBP (effect size, 0.0 [95% CI, -0.8 to 0.8] mm Hg; P=.97; I2=21%) or DBP (effect size, -0.1 [95% CI, -0.6 to 0.5] mm Hg; P=.84; I2=20%). Similar results were found analyzing individual patient data for SBP (effect size, -0.5 [95% CI, -1.3 to 0.4] mm Hg; P=.27; I2=0%) and DBP (effect size, 0.2 [95% CI, -0.3 to 0.7] mm Hg; P=.38; I2=0%). Subgroup analysis did not reveal any baseline factor predictive of a better response to therapy.
Conclusions and relevance
Vitamin D supplementation is ineffective as an agent for lowering BP and thus should not be used as an antihypertensive agent.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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