Vitamin D deficiency, insufficiency and pulse pressure

Background: Suboptimal vitamin D remains common and increases the risk of many chronic illnesses, including infectious diseases, cardiovascular disease and common cancers. However, the relationship between suboptimal vitamin D and the risk of increased pulse pressure associated with cardiovascular events has not been well characterized.

Methods: Cross-sectional data of 15,296 participants aged 18 years or older were collected from the 2001-2006 National Health and Nutrition Examination Survey (mean age 46 years; 50% women; 72% white, 12% Hispanic and 11% black). The regression coefficients of pulse pressure across levels of serum 25(OH)D (>30, 20-30 and <20 ng/ml) were estimated by conducting weighted multiple regression analyses. The adjusted odds ratios with 95% confidence intervals for abnormal pulse pressure were estimated using the weighted log-binomial method.

Results: After adjustment for potential confounding factors, participants with vitamin D deficiency are 75% (odds ratio [OR]: 1.75; 95% confidence interval [CI]: 1.37-2.23) more likely to have a pulse pressure ≥60 mmHg than those with normal vitamin D. Average pulse pressure increased by 2.25 mmHg (95% CI: 1.17-3.33) for vitamin D deficiency relative to normal levels. Vitamin D insufficiency increased continuous pulse pressure by 0.95 mmHg (95% CI: 0.21-1.69) compared with normal vitamin D levels. The risk of hypertension increased by 68% (OR: 1.68; 95% CI: 1.24-2.28) for vitamin D deficiency and 23% (OR: 1.23; 95% CI: 1.02-1.48) for vitamin D insufficiency.

Conclusion: Vitamin D deficiency and insufficiency are associated with pulse pressure and with the risk of abnormally high pulse pressure although causal effects remain to be investigated.