BACKGROUND: Higher prevalence of hypertension among African Americans is a key cause of racial disparity in cardiovascular morbidity and mortality. Explanations for the difference in prevalence are incomplete. Emerging data suggest that low vitamin D levels may contribute. OBJECTIVE: To assess the contribution of vitamin D to racial disparity in blood pressure. DESIGN: Cross-sectional analysis. PARTICIPANTS: Adult non-Hispanic Black and White participants from the National Health and Nutrition Examination Survey 2001-2006. MEASURES: We assessed Black-White differences in systolic blood pressure (SBP) controlling for conventional risk factors, and then additionally, for vitamin D (serum 25[OH]D). RESULTS: The sample included 1984 and 5156 Black and White participants ages 20 years and older. The mean age-sex adjusted Black-White SBP difference was 5.2 mm Hg. This difference was reduced to 4.0 mm Hg with additional adjustment for socio-demographic characteristics, health status, health care, health behaviors, and biomarkers; adding 25(OH)D reduced the race difference by 26% (95% CI 7-46%) to 2.9 mm Hg. This effect increased to 39% (95% CI 14-65%) when those on antihypertensive medications were excluded. Supplementary analyses that controlled for cardiovascular fitness, percent body fat, physical activity monitoring, skin type and social support yielded consistent results. CONCLUSION: In cross-sectional analyses, 25(OH)D explains one quarter of the Black-White disparity in SBP. Randomized controlled trials are required to determine whether vitamin D supplementation could reduce racial disparity in BP.
BACKGROUND: Higher prevalence of hypertension among African Americans is a key cause of racial disparity in cardiovascular morbidity and mortality. Explanations for the difference in prevalence are incomplete. Emerging data suggest that low vitamin D levels may contribute. OBJECTIVE: To assess the contribution of vitamin D to racial disparity in blood pressure. DESIGN: Cross-sectional analysis. PARTICIPANTS: Adult non-Hispanic Black and White participants from the National Health and Nutrition Examination Survey 2001-2006. MEASURES: We assessed Black-White differences in systolic blood pressure (SBP) controlling for conventional risk factors, and then additionally, for vitamin D (serum 25[OH]D). RESULTS: The sample included 1984 and 5156 Black and White participants ages 20 years and older. The mean age-sex adjusted Black-White SBP difference was 5.2 mm Hg. This difference was reduced to 4.0 mm Hg with additional adjustment for socio-demographic characteristics, health status, health care, health behaviors, and biomarkers; adding 25(OH)D reduced the race difference by 26% (95% CI 7-46%) to 2.9 mm Hg. This effect increased to 39% (95% CI 14-65%) when those on antihypertensive medications were excluded. Supplementary analyses that controlled for cardiovascular fitness, percent body fat, physical activity monitoring, skin type and social support yielded consistent results. CONCLUSION: In cross-sectional analyses, 25(OH)D explains one quarter of the Black-White disparity in SBP. Randomized controlled trials are required to determine whether vitamin D supplementation could reduce racial disparity in BP.
Authors: Jan L Houghton; Edward F Philbin; David S Strogatz; Mikhail T Torosoff; Steven A Fein; Patricia A Kuhner; Vivienne E Smith; Albert A Carr Journal: J Am Coll Cardiol Date: 2002-04-17 Impact factor: 24.094
Authors: Umberto Campia; Wassim K Choucair; Melissa B Bryant; Myron A Waclawiw; Carmine Cardillo; Julio A Panza Journal: J Am Coll Cardiol Date: 2002-08-21 Impact factor: 24.094
Authors: Jaeyoung Hong; Kathryn E Hatchell; Jonathan P Bradfield; Andrew Bjonnes; Alessandra Chesi; Chao-Qiang Lai; Carl D Langefeld; Lingyi Lu; Yingchang Lu; Pamela L Lutsey; Solomon K Musani; Mike A Nalls; Cassianne Robinson-Cohen; Jeffery D Roizen; Richa Saxena; Katherine L Tucker; Julie T Ziegler; Dan E Arking; Joshua C Bis; Eric Boerwinkle; Erwin P Bottinger; Donald W Bowden; Vicente Gilsanz; Denise K Houston; Heidi J Kalkwarf; Andrea Kelly; Joan M Lappe; Yongmei Liu; Erin D Michos; Sharon E Oberfield; Nicholette D Palmer; Jerome I Rotter; Bishwa Sapkota; John A Shepherd; James G Wilson; Saonli Basu; Ian H de Boer; Jasmin Divers; Barry I Freedman; Struan F A Grant; Hakon Hakanarson; Tamara B Harris; Bryan R Kestenbaum; Stephen B Kritchevsky; Ruth J F Loos; Jill M Norris; Arnita F Norwood; Jose M Ordovas; James S Pankow; Bruce M Psaty; Dharambir K Sanghera; Lynne E Wagenknecht; Babette S Zemel; James Meigs; Josée Dupuis; Jose C Florez; Thomas Wang; Ching-Ti Liu; Corinne D Engelman; Liana K Billings Journal: J Clin Endocrinol Metab Date: 2018-04-01 Impact factor: 5.958