Effects of vitamin D on blood pressure, arterial stiffness, and cardiac function in older people after 1 year: BEST‐D (Biochemical Efficacy and Safety Trial of Vitamin D)

摘要

The relevance of vitamin D for prevention of cardiovascular disease is uncertain. The BEST-D trial previously reported effects of vitamin D on plasma markers of vitamin D status, and the present report describes the effects on blood pressure, heart rate, arterial stiffness and cardiac function. Randomized, double-blind, placebo-controlled trial of 305 older people living in UK, allocated vitamin D 4000 IU (100 μg), vitamin D 2000 IU (50 μg), or placebo daily. Primary outcomes were plasma concentrations of 25-hydroxy-vitamin D (25[OH]D) and secondary outcomes were blood pressure, heart rate and arterial stiffness in all participants at 6 and 12 months, plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) levels in all participants at 12 months, and echocardiographic measures of cardiac function in a randomly selected subset (n=177) at 12 months. Mean (SE) plasma 25(OH)D concentrations were 50 (SE 2) nmol/L at baseline and increased to 137 (2.4), 102 (2.4) and 55 (2.4) nmol/L after 12 months in those allocated 4000 IU/day, 2000 IU/day of vitamin D or placebo, respectively. Allocation to vitamin D had no significant effect on mean levels of blood pressure, heart rate or arterial stiffness at either 6 or 12 months, nor on any echocardiographic measures of cardiac function, or plasma NT-proBNP concentration at 12 months. The absence of any significant effect of vitamin D on blood pressure, arterial stiffness or cardiac function suggests that any beneficial effects of vitamin D on cardiovascular disease are unlikely to be mediated through these mechanisms.