Effect of vitamin D supplementation on orthostatic hypotension: data from the Vitamin D in Isolated Systolic Hypertension randomized controlled trial

Miles D. Witham (Lead / Corresponding author), Rosemary J G Price, Allan D. Struthers, Peter T. Donnan, Martina Messow, Alex McConnachie, Ian Ford, Marion E T McMurdo

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    7 Citations (Scopus)

    Abstract

    OBJECTIVE: Orthostatic hypotension commonly accompanies supine hypertension, and is associated with low 25-hydroxyvitamin D levels. We tested whether high-dose intermittent oral vitamin D therapy could ameliorate orthostatic hypotension in older patients with isolated systolic hypertension. METHODS:: We conducted a subgroup analysis of data from a parallel-group, double-blind, randomized, placebo-controlled trial. Patients aged over 70 years with supine office SBP above 140 mmHg and DBP below 90 mmHg received 100 000 units oral vitamin D3 or matching placebo every 3 months for 1 year. Office supine and standing blood pressure were measured at baseline, and 3, 6, 9 and 12 months, along with arterial stiffness and flow-mediated dilatation of the brachial artery. RESULTS:: Of 159 patients randomized to the main trial, 75 patients with orthostatic hypotension at baseline were included in this analysis. The mean age was 78 (SD 5) years, baseline blood pressure was 162/76 mmHg and the mean baseline orthostatic fall in blood pressure on standing was 32/5 mmHg. After adjustment for baseline age, 25-hydroxyvitamin D, SBP and orthostatic fall, the fall in SBP was less in the vitamin D group at 3 months [treatment effect 6 mmHg, 95% confidence interval (CI) 0 to 12], but repeated-measures analysis showed no significant treatment effect (3 mmHg for systolic fall, 95% CI -1 to 8; 1 mmHg for diastolic fall, 95% CI -1 to 3). CONCLUSION:: Twelve months of intermittent, high-dose oral vitamin D3 did not significantly improve orthostatic hypotension in older patients with isolated systolic hypertension.

    Original languageEnglish
    Pages (from-to)1693-1699
    Number of pages7
    JournalJournal of Hypertension
    Volume32
    Issue number8
    DOIs
    Publication statusPublished - 1 Aug 2014

    Fingerprint

    Orthostatic Hypotension
    Vitamin D
    Randomized Controlled Trials
    Hypertension
    Cholecalciferol
    Confidence Intervals
    Blood Pressure
    Placebos
    Vascular Stiffness
    Brachial Artery
    Dilatation
    Therapeutics

    Keywords

    • older
    • orthostatic hypotension
    • randomized controlled trial
    • vitamin D

    Cite this

    @article{c8ad75aa1d104ad99a8bf338757edb6a,
    title = "Effect of vitamin D supplementation on orthostatic hypotension: data from the Vitamin D in Isolated Systolic Hypertension randomized controlled trial",
    abstract = "OBJECTIVE: Orthostatic hypotension commonly accompanies supine hypertension, and is associated with low 25-hydroxyvitamin D levels. We tested whether high-dose intermittent oral vitamin D therapy could ameliorate orthostatic hypotension in older patients with isolated systolic hypertension. METHODS:: We conducted a subgroup analysis of data from a parallel-group, double-blind, randomized, placebo-controlled trial. Patients aged over 70 years with supine office SBP above 140 mmHg and DBP below 90 mmHg received 100 000 units oral vitamin D3 or matching placebo every 3 months for 1 year. Office supine and standing blood pressure were measured at baseline, and 3, 6, 9 and 12 months, along with arterial stiffness and flow-mediated dilatation of the brachial artery. RESULTS:: Of 159 patients randomized to the main trial, 75 patients with orthostatic hypotension at baseline were included in this analysis. The mean age was 78 (SD 5) years, baseline blood pressure was 162/76 mmHg and the mean baseline orthostatic fall in blood pressure on standing was 32/5 mmHg. After adjustment for baseline age, 25-hydroxyvitamin D, SBP and orthostatic fall, the fall in SBP was less in the vitamin D group at 3 months [treatment effect 6 mmHg, 95{\%} confidence interval (CI) 0 to 12], but repeated-measures analysis showed no significant treatment effect (3 mmHg for systolic fall, 95{\%} CI -1 to 8; 1 mmHg for diastolic fall, 95{\%} CI -1 to 3). CONCLUSION:: Twelve months of intermittent, high-dose oral vitamin D3 did not significantly improve orthostatic hypotension in older patients with isolated systolic hypertension.",
    keywords = "older, orthostatic hypotension, randomized controlled trial, vitamin D",
    author = "Witham, {Miles D.} and Price, {Rosemary J G} and Struthers, {Allan D.} and Donnan, {Peter T.} and Martina Messow and Alex McConnachie and Ian Ford and McMurdo, {Marion E T}",
    year = "2014",
    month = "8",
    day = "1",
    doi = "10.1097/HJH.0000000000000223",
    language = "English",
    volume = "32",
    pages = "1693--1699",
    journal = "Journal of Hypertension",
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    }

    TY - JOUR

    T1 - Effect of vitamin D supplementation on orthostatic hypotension

    T2 - data from the Vitamin D in Isolated Systolic Hypertension randomized controlled trial

    AU - Witham, Miles D.

    AU - Price, Rosemary J G

    AU - Struthers, Allan D.

    AU - Donnan, Peter T.

    AU - Messow, Martina

    AU - McConnachie, Alex

    AU - Ford, Ian

    AU - McMurdo, Marion E T

    PY - 2014/8/1

    Y1 - 2014/8/1

    N2 - OBJECTIVE: Orthostatic hypotension commonly accompanies supine hypertension, and is associated with low 25-hydroxyvitamin D levels. We tested whether high-dose intermittent oral vitamin D therapy could ameliorate orthostatic hypotension in older patients with isolated systolic hypertension. METHODS:: We conducted a subgroup analysis of data from a parallel-group, double-blind, randomized, placebo-controlled trial. Patients aged over 70 years with supine office SBP above 140 mmHg and DBP below 90 mmHg received 100 000 units oral vitamin D3 or matching placebo every 3 months for 1 year. Office supine and standing blood pressure were measured at baseline, and 3, 6, 9 and 12 months, along with arterial stiffness and flow-mediated dilatation of the brachial artery. RESULTS:: Of 159 patients randomized to the main trial, 75 patients with orthostatic hypotension at baseline were included in this analysis. The mean age was 78 (SD 5) years, baseline blood pressure was 162/76 mmHg and the mean baseline orthostatic fall in blood pressure on standing was 32/5 mmHg. After adjustment for baseline age, 25-hydroxyvitamin D, SBP and orthostatic fall, the fall in SBP was less in the vitamin D group at 3 months [treatment effect 6 mmHg, 95% confidence interval (CI) 0 to 12], but repeated-measures analysis showed no significant treatment effect (3 mmHg for systolic fall, 95% CI -1 to 8; 1 mmHg for diastolic fall, 95% CI -1 to 3). CONCLUSION:: Twelve months of intermittent, high-dose oral vitamin D3 did not significantly improve orthostatic hypotension in older patients with isolated systolic hypertension.

    AB - OBJECTIVE: Orthostatic hypotension commonly accompanies supine hypertension, and is associated with low 25-hydroxyvitamin D levels. We tested whether high-dose intermittent oral vitamin D therapy could ameliorate orthostatic hypotension in older patients with isolated systolic hypertension. METHODS:: We conducted a subgroup analysis of data from a parallel-group, double-blind, randomized, placebo-controlled trial. Patients aged over 70 years with supine office SBP above 140 mmHg and DBP below 90 mmHg received 100 000 units oral vitamin D3 or matching placebo every 3 months for 1 year. Office supine and standing blood pressure were measured at baseline, and 3, 6, 9 and 12 months, along with arterial stiffness and flow-mediated dilatation of the brachial artery. RESULTS:: Of 159 patients randomized to the main trial, 75 patients with orthostatic hypotension at baseline were included in this analysis. The mean age was 78 (SD 5) years, baseline blood pressure was 162/76 mmHg and the mean baseline orthostatic fall in blood pressure on standing was 32/5 mmHg. After adjustment for baseline age, 25-hydroxyvitamin D, SBP and orthostatic fall, the fall in SBP was less in the vitamin D group at 3 months [treatment effect 6 mmHg, 95% confidence interval (CI) 0 to 12], but repeated-measures analysis showed no significant treatment effect (3 mmHg for systolic fall, 95% CI -1 to 8; 1 mmHg for diastolic fall, 95% CI -1 to 3). CONCLUSION:: Twelve months of intermittent, high-dose oral vitamin D3 did not significantly improve orthostatic hypotension in older patients with isolated systolic hypertension.

    KW - older

    KW - orthostatic hypotension

    KW - randomized controlled trial

    KW - vitamin D

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    U2 - 10.1097/HJH.0000000000000223

    DO - 10.1097/HJH.0000000000000223

    M3 - Article

    C2 - 24879494

    AN - SCOPUS:84904044663

    VL - 32

    SP - 1693

    EP - 1699

    JO - Journal of Hypertension

    JF - Journal of Hypertension

    SN - 0263-6352

    IS - 8

    ER -