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 of Vitamin D Levels with the Extent and Severity of Coronary Artery Disease.

Aims: Vitamin D is known for its primary role in calcium and bone homeostasis and regulation of parathyroid hormone (PTH) secretion. There is increasing evidence for health benefits accomplished by activated vitamin D, that go beyond these classical functions. Previous studies have suggested that lower Vitamin D levels are associated with increased cardiovascular disease (CVD) risk. Therefore, we aimed to evaluate relationship between vit D levels and extent and severity of coronary artery disease. Study Design: Cross-sectional. Place and Duration of Study: Sample: Department of Cardiology, Bagcilar Training and Research Hospital between November 2009 and march 2010. Methodology: We evaluated 135 patients who underwent elective coronary angiography between November 2009 and march 2010. Patients with renal failure(GFR less than 60ml/min per 1.73m2), history of malignancy within the past 5 years, any predominant non-cardiac disease, patients using any vitamin D supplement or with hyperparathyroidism or hypercalcemia were excluded. The severity and extent of CAD were determined using the Gensini score. And, patients were classified as having advanced (≥40) or mild (<40) CAD according to the Gensini scores. Results: The mean 25-OH D concentration was 18.7ng/mL. The overall prevalence of 25- OH D less then 15ng/mL was 34,8%(n=47), with 11% having 25-OH D less then 10ng/mL. Multivariate analysis revaeled that smoking, presence of hyperlipidemia, higher CRP levels, higher ALP levels and low levels of 25-OH D concentrations were significantly associated with higher Gensini Scores. Conclusion: In our study, we found significant correlation between low vitamin D levels and higher Gensini scores.