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Terapia con vitamina D en personas con prehipertensión o hipertensión: el ensayo DAYLIGHT

Pankaj Arora¹, Yanna Song¹, Jeffery Dusek¹

¹From the Cardiology Division, Department of Medicine, University of Alabama at Birmingham, Birmingham (P.A.); Department of Biostatistics (Y.S., F.H.) and Division of Cardiovascular Medicine, Department of Medicine (D.C.O., T.J.W.), Vanderbilt University, Nashville, TN; Integrative Health Research Center, Abbott Northwestern Hospital, Minneapolis, MN (J.D., G.P.); Division of Cardiology, Department of Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, MA (M.S.S., S.C.); Esoterix Clinical Lab Services, LabCorp, Research Triangle Park, NC (A.V.); Division of Cardiology, Department of Medicine, Hartford Hospital, Hartford, CT (H.S., B.T.); Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (E.C., D.G., J.R.Y., C.K., M.T., C.N.-C.); Division of Cardiology, Cultural Wellness Center, Minneapolis, MN (A.A., S.M.S.); and Division of Nephrology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL (M.W.).

|November 1, 2014

Resumen

La suplementación de dosis altas de vitamina D no redujo la presión arterial en personas con deficiencia de vitamina D y prehipertensión o hipertensión en etapa I. Estos hallazgos sugieren que el vínculo entre los niveles de vitamina D y la presión arterial en estudios observacionales puede no ser causal.

Área de la Ciencia:

Endocrinología Endocrinología.
Ciencias de la Nutrición Ciencias de la Nutrición
Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.

Sus antecedentes:

Los estudios de observación sugieren un vínculo entre la deficiencia de vitamina D y la hipertensión.
La suplementación de vitamina D es una intervención potencial y simple para reducir la presión arterial.
Existen datos limitados de ensayos controlados aleatorios sobre la suplementación de vitamina D y la presión arterial.

Objetivo del estudio:

Investigar el efecto de la suplementación de dosis altas versus dosis bajas de vitamina D3 en la presión arterial en individuos con deficiencia de vitamina D y presión arterial elevada.
Para determinar si la suplementación de vitamina D puede reducir la presión arterial sistólica y diastólica en una población deficiente.

Principales métodos:

Un ensayo doble ciego, aleatorizado y controlado en el que participaron 534 adultos (18-50 años) con bajo estado de vitamina D (≤25 ng/mL) y presión arterial sistólica (120-159 mm Hg).
Los participantes recibieron dosis altas (4000 UI/d) o dosis bajas (400 UI/d) de vitamina D3 oral durante 6 meses.
El objetivo primario fue el cambio en la presión arterial sistólica media de 24 horas; los objetivos secundarios incluyeron mediciones de presión arterial ambulatoriales y clínicas.

Principales resultados:

No se observó diferencia significativa en el criterio de valoración primario (cambio en la presión arterial sistólica media de 24 horas) entre los grupos de dosis alta y baja de vitamina D (-0,8 vs -1,6 mm Hg; P=0,71).
Los puntos finales secundarios, incluida la presión arterial ambulatoria y clínica, tampoco mostraron diferencias significativas entre los grupos.
No se encontró asociación entre el cambio en los niveles de 25-hidroxivitamina D y el cambio en la presión arterial sistólica de 24 horas (correlación de Spearman -0.05, P=0.34).

Conclusiones:

La suplementación de vitamina D no redujo efectivamente la presión arterial en personas con prehipertensión o hipertensión en etapa I y deficiencia concurrente de vitamina D.
La asociación observada entre el estado de vitamina D y la presión arterial elevada en estudios observacionales puede no ser causal.
Es posible que se necesite más investigación para explorar otros roles potenciales de la vitamina D en la salud cardiovascular.

Palabras clave:

Presión arterial presión arterial presión arterial suplementos alimenticios suplementos alimenticios La hipertensión es la hipertensión.La deficiencia de vitamina D es una deficiencia de vitamina D.

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