The aim of the study was to evaluate the impact of cholecalciferol supplementation on blood pressure (BP) in patients with arterial hypertension (AH) stage II.Design and method:
A prospective, cohort, single-center study of 144 individuals with stage II AH (50.6 ± 7.3 years) was performed. Antihypertensive therapy was administered according to 2013 ESH/ESC guidelines for the management of AH. In addition to antihypertensive therapy every second patient on the alphabetical list was recommended to take cholecalciferol 2,000 IU/day daily. The duration of cholecalciferol supplementation was 4.4 ± 2.2 months. The serum level of 25(OH)D total (ng/ml) was determined by the immunoenzymatic assay using the DRG reagent (Germany, Marburg). The duration of follow-up was 15.8 ± 1.8 months. The “dynamics” (d) index was calculated as a difference between values before and after administered therapy.Results:
At baseline office systolic (SBP) and diastolic BP (DBP) averaged at 150[140;160]/90[90;100] mmHg. On the follow-up there were their significant (p < 0,0001) reduction and were 130[125;140]/80[80;90] mmHg correspondingly. Target levels of office BP measurements were achieved in 83.9% for SBP and 87.1% for DBP. Serum 25(OH)D total at baseline was 24.8[17.02; 34.06] ng/ml, at the end of the follow-up period – 41.7[33.1; 53.5] ng/ml (p = 0.00001). We established a significant influence of cholecalciferol supplementation on dSBP (F = 4.1; p = 0.046). Correlation relationship between dSBP and duration of cholecalciferol intake was established (R = 0.42; p = 0.023). It was found that intake of diuretics (hydrochlorothiazide at a dose of 12.5 mg and higher, or indapamide 1.5 mg or higher) as part of combination of antihypertensive therapy influenced the dynamics of serum 25(OH)D (F = 5.35;p = 0.02) and its level (F = 11.8; p = 0.0009). The highest d25(OH)D was found in the group of patients without diuretics intake. dSBP value was highest (−27.4 ± 17.9) in the group receiving diuretics and cholecalciferol, which was significantly (p < 0.001) different from the comparison group.Conclusions:
The combined use of cholecalciferol at a dose of 2000 IU/day and diuretic in the treatment of patients with AH stage II allowed to obtain the greatest hypotensive effect on SBP.