Assessment of 25-hydroxyvitamin D levels in patients with resistant hypertension

Objective: To investigate the possible correlation between serum 25-hydroxyvitamin D levels and resistant hypertension [RH]

Subjects and Methods: Patients who had undergone ambulatory blood pressure measurements [ABPM] during outpatient controls were enrolled. Fifty subjects with RH, 50 with controlled hypertension [CHT] and 50 normotensive subjects [NT] were included in the study. RH was defined as 'suboptimal blood pressure control despite using 3 antihypertensive agents including a diuretic or need for 4 or more drugs to control blood pressure'. The 25-hydroxyvitamin D and parathormone levels were compared between the groups. Pearson's correlation coefficient test was applied to assess the correlation between 25-hydroxyvitamin D levels and office blood pressure [BP] and ABPM. Logistic regression analysis was used to determine the independent correlates of RH

Results: The 25-hydroxyvitamin D level was significantly lower in the RH group [17.02 +/- 5.4 ng/ml] compared to the CHT [24.9 +/- 4.8 ng/ml] and NT groups [28.0 +/- 5.7 ng/ml, p < 0.001]. In univariate correlation analysis, 25-hydroxyvitamin D levels had a significant negative correlation with office systolic BP [r = -0.329, p < 0.001], office diastolic BP [r = -0.395, p < 0.001], systolic ambulatory BP [r = -0.844, p = 0.004], and diastolic ambulatory BP [r = -0.567, p = 0.005]. ROC analysis revealed that 25-hydroxyvitamin D levels <21.50 ng/ml predicted the presence of RH with a sensitivity of 78% and a specificity of 79% [AUC = 0.89, 95% CI 0.83-0.94]. In the multivariate logistic regression analysis, 25-hydroxyvitamin D level was independently correlated with the presence of RH [beta 0.660, 95% CI 0.572-0.760, p < 0.001]

Conclusion: There was an independent correlation between lower 25-hydroxyvitamin D levels and presence of RH

The Association between Subclinical Hypothyroidism and Epicardial Adipose Tissue Thickness

BACKGROUND AND OBJECTIVES: Subclinical hypothyroidism (SH) is considered to be a potential risk factor for cardiovascular disease. Epicardial adipose tissue (EAT) thickness is also closely related to cardiovascular disorders. The aim of this study was to evaluate whether SH is associated with higher EAT thickness. SUBJECTS AND METHODS: Fifty-one consecutive patients with SH and 51 healthy control subjects were prospectively enrolled into this trial. Thyroid hormone levels, lipid parameters, body mass index, waist and neck circumference, and EAT thickness measured by echocardiography were recorded in all subjects. RESULTS: Mean EAT thickness was increased in the SH group compared to the control group (6.7+/-1.4 mm vs. 4.7+/-1.2 mm, p<0.001). EAT thickness was shown to be correlated with thyroid stimulating hormone level (r=0.303, p=0.002). Multivariate logistic regression analysis revealed that EAT thickness was independently associated with SH {odds ratio (OR): 3.87, 95% confidence interval (CI): 1.92-7.78, p<0.001; OR: 3.80, 95% CI: 2.18-6.62, p<0.001}. CONCLUSION: Epicardial adipose tissue thickness is increased in patients with SH compared to control subjects, and this increase in EAT thickness may be associated with the potential cardiovascular adverse effects of SH.