Cholecalciferol treatment downregulates renin-angiotensin system and improves endothelial function in essential hypertensive patients with hypovitaminosid D
Carrara D, Bruno RM, Bacca A, Taddei S, Duranti E, Ghiadoni L, Bernini G
Journal of hypertension · 25 citas
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Cómo se estudió
- Diseño
- Ensayo clínico controlado (clasificado por nuestro filtro de IA)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2016-09-20 · J Hypertens · vol. 34 · número 11 · págs. 2199–2205
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 37 citas · más que el 92% de estudios similares · 3.2× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 64 trabajos
- Acceso
- De pago
- Áreas de investigación
- Vitamin D Research Studies · Cardiovascular Health and Disease Prevention · Cardiovascular Disease and Adiposity
- Palabras clave
- Medicine, Internal medicine, Endocrinology, Cholecalciferol, Aldosterone, Vitamin D and neurology, Plasma renin activity, Renin–angiotensin system, Angiotensin II, Vasodilation, Brachial artery, Essential hypertension, Blood pressure
- MeSH
- endothelium, humans, cardiovascular diseases, hypertension, vitamin d deficiency, cholecalciferol, aldosterone, renin, vitamins, vitamin d, angiotensin ii, renin-angiotensin system, blood pressure, vasodilation, adult, middle aged, female, male, pulse wave analysis, essential hypertension
7 autores
- Davide Carrara🇮🇹🇺🇸University of Pisa; May Institute
- Rosa María Bruno🇮🇹🇺🇸University of Pisa; May Institute
- Alessandra Bacca🇮🇹🇺🇸University of Pisa; May Institute
- Stefano Taddei🇮🇹🇺🇸University of Pisa; May Institute
- Emiliano Duranti🇮🇹🇺🇸University of Pisa; May Institute
- Lorenzo Ghiadoni🇮🇹🇺🇸University of Pisa; May Institute
- Giampaolo P. Bernini🇮🇹🇺🇸 · autor de correspondenciaUniversity of Pisa; May Institute
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Vitamin D deficiency is related to an increased prevalence of cardiovascular disease. Renin-angiotensin-aldosterone system suppression and vascular dysfunction are considered among the main mechanisms implicated in this association. However, interventional studies demonstrating that vitamin D replacement reduces circulating renin-angiotensin-aldosterone components and improves vascular function in humans are still lacking.
Methods
Thirty-three consecutive patients with essential hypertension and hypovitaminosis D underwent therapy with cholecalciferol 50 000 IU/week orally for 8 weeks. Thirty-three hypertensive patients with normal vitamin D levels and 20 normotensive individuals were also enrolled as control groups. At baseline and at the end of the study, we evaluated plasma renin activity, circulating renin, angiotensin II, aldosterone and plasma vitamin D levels. Endothelial function [flow-mediated dilation (FMD)], carotid-femoral pulse wave velocity and augmentation index, peripheral and central blood pressure were also acquired.
Results
After 8-week cholecalciferol administration, all treated patients normalized plasma 25(OH)D values. Furthermore, a reduction in plasma levels of plasma renin activity (1.17 ± 0.3 vs 1.51 ± 0.4 ng/ml per h, P = 0.02), renin (13.4 ± 1.7 vs 19.2 ± 2.9 pg/ml, P < 0.001), angiotensin II (11.6 ± 1.6 vs 15.8 ± 2.7 pg/ml, P = 0.02) was observed at the end of the study. FMD was significantly increased after cholecalciferol treatment (4.4 ± 2.6 vs 3.3 ± 2.1%, P < 0.05), in the absence of changes of brachial artery diameter and endothelium-independent vasodilation. Carotid-femoral pulse wave velocity and augmentation index were not modified, as well peripheral and central blood pressure.
Conclusion
The restoration of normal vitamin D levels after 8-week cholecalciferol treatment is able to inhibit peripheral renin-angiotensin system and improve FMD in essential hypertensive patients with hypovitaminosis D.
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