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Meta-Analysis
. 2014 Sep;2(9):719-29.
doi: 10.1016/S2213-8587(14)70113-5. Epub 2014 Jun 25.

Association of vitamin D status with arterial blood pressure and hypertension risk: a mendelian randomisation study

Karani S Vimaleswaran  1 Alana Cavadino  2 Diane J Berry  2 LifeLines Cohort Study investigatorsRolf Jorde  3 Aida Karina Dieffenbach  4 Chen Lu  5 Alexessander Couto Alves  6 Hiddo J Lambers Heerspink  7 Emmi Tikkanen  8 Joel Eriksson  9 Andrew Wong  10 Massimo Mangino  11 Kathleen A Jablonski  12 Ilja M Nolte  13 Denise K Houston  14 Tarunveer Singh Ahluwalia  15 Peter J van der Most  13 Dorota Pasko  16 Lina Zgaga  17 Elisabeth Thiering  18 Veronique Vitart  19 Ross M Fraser  20 Jennifer E Huffman  19 Rudolf A de Boer  21 Ben Schöttker  4 Kai-Uwe Saum  4 Mark I McCarthy  22 Josée Dupuis  23 Karl-Heinz Herzig  24 Sylvain Sebert  25 Anneli Pouta  26 Jaana Laitinen  27 Marcus E Kleber  28 Gerjan Navis  29 Mattias Lorentzon  9 Karen Jameson  30 Nigel Arden  31 Jackie A Cooper  32 Jayshree Acharya  32 Rebecca Hardy  10 Olli Raitakari  33 Samuli Ripatti  34 Liana K Billings  35 Jari Lahti  36 Clive Osmond  30 Brenda W Penninx  37 Lars Rejnmark  38 Kurt K Lohman  39 Lavinia Paternoster  40 Ronald P Stolk  13 Dena G Hernandez  41 Liisa Byberg  42 Emil Hagström  43 Håkan Melhus  43 Erik Ingelsson  44 Dan Mellström  9 Osten Ljunggren  43 Ioanna Tzoulaki  45 Stela McLachlan  20 Evropi Theodoratou  20 Carla M T Tiesler  46 Antti Jula  47 Pau Navarro  19 Alan F Wright  19 Ozren Polasek  48 International Consortium for Blood Pressure (ICBP)Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortiumGlobal Blood Pressure Genetics (Global BPGen) consortiumCaroline HaywardJames F Wilson  20 Igor Rudan  20 Veikko Salomaa  49 Joachim Heinrich  50 Harry Campbell  20 Jacqueline F Price  20 Magnus Karlsson  51 Lars Lind  43 Karl Michaëlsson  42 Stefania Bandinelli  52 Timothy M Frayling  16 Catharina A Hartman  53 Thorkild I A Sørensen  54 Stephen B Kritchevsky  14 Bente Lomholt Langdahl  38 Johan G Eriksson  55 Jose C Florez  56 Tim D Spector  11 Terho Lehtimäki  57 Diana Kuh  10 Steve E Humphries  32 Cyrus Cooper  31 Claes Ohlsson  9 Winfried März  58 Martin H de Borst  29 Meena Kumari  59 Mika Kivimaki  59 Thomas J Wang  60 Chris Power  2 Hermann Brenner  4 Guri Grimnes  3 Pim van der Harst  21 Harold Snieder  13 Aroon D Hingorani  61 Stefan Pilz  62 John C Whittaker  63 Marjo-Riitta Järvelin  64 Elina Hyppönen  65
Affiliations
Meta-Analysis

Association of vitamin D status with arterial blood pressure and hypertension risk: a mendelian randomisation study

Karani S Vimaleswaran et al. Lancet Diabetes Endocrinol. 2014 Sep.

Abstract

Background: Low plasma 25-hydroxyvitamin D (25[OH]D) concentration is associated with high arterial blood pressure and hypertension risk, but whether this association is causal is unknown. We used a mendelian randomisation approach to test whether 25(OH)D concentration is causally associated with blood pressure and hypertension risk.

Methods: In this mendelian randomisation study, we generated an allele score (25[OH]D synthesis score) based on variants of genes that affect 25(OH)D synthesis or substrate availability (CYP2R1 and DHCR7), which we used as a proxy for 25(OH)D concentration. We meta-analysed data for up to 108 173 individuals from 35 studies in the D-CarDia collaboration to investigate associations between the allele score and blood pressure measurements. We complemented these analyses with previously published summary statistics from the International Consortium on Blood Pressure (ICBP), the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) consortium, and the Global Blood Pressure Genetics (Global BPGen) consortium.

Findings: In phenotypic analyses (up to n=49 363), increased 25(OH)D concentration was associated with decreased systolic blood pressure (β per 10% increase, -0·12 mm Hg, 95% CI -0·20 to -0·04; p=0·003) and reduced odds of hypertension (odds ratio [OR] 0·98, 95% CI 0·97-0·99; p=0·0003), but not with decreased diastolic blood pressure (β per 10% increase, -0·02 mm Hg, -0·08 to 0·03; p=0·37). In meta-analyses in which we combined data from D-CarDia and the ICBP (n=146 581, after exclusion of overlapping studies), each 25(OH)D-increasing allele of the synthesis score was associated with a change of -0·10 mm Hg in systolic blood pressure (-0·21 to -0·0001; p=0·0498) and a change of -0·08 mm Hg in diastolic blood pressure (-0·15 to -0·02; p=0·01). When D-CarDia and consortia data for hypertension were meta-analysed together (n=142 255), the synthesis score was associated with a reduced odds of hypertension (OR per allele, 0·98, 0·96-0·99; p=0·001). In instrumental variable analysis, each 10% increase in genetically instrumented 25(OH)D concentration was associated with a change of -0·29 mm Hg in diastolic blood pressure (-0·52 to -0·07; p=0·01), a change of -0·37 mm Hg in systolic blood pressure (-0·73 to 0·003; p=0·052), and an 8·1% decreased odds of hypertension (OR 0·92, 0·87-0·97; p=0·002).

Interpretation: Increased plasma concentrations of 25(OH)D might reduce the risk of hypertension. This finding warrants further investigation in an independent, similarly powered study.

Funding: British Heart Foundation, UK Medical Research Council, and Academy of Finland.

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Conflict of interest statement

Declaration of interests

TJW is on the scientific advisory board for DiaSorin and has received research support from the company. JCW is employed by GlaxoSmithKline and holds shares in the company. JCF has received honoraria from Lilly for consulting. All other authors declare no competing interests.

Figures

Figure 1
Figure 1. Flow chart showing the sample sizes available at each stage of the meta-analyses
25(OH)D=25-hydroxyvitamin D. ICBP=International Consortium for Blood Pressure. CHARGE=Cohorts for Heart and Aging Research in Genomic Epidemiology. Global BPGen=Global Blood Pressure Genetics. *Did not contribute data to analyses with the synthesis score single-nucleotide polymorphisms (SNPs) because of unavailability of the CYP3R3 SNP. Did not contribute data to analyses with the metabolism score SNPs because of unavailability of GC or CYP33A3 SNPs.
Figure 2
Figure 2. Meta-analysis of D-CarDia studies with summary data from the ICBP, CHARGE, and Global BPGen consortia
Association of the synthesis score with systolic blood pressure, diastolic blood pressure, and hypertension. Includes data for 146 581 individuals, after exclusion of overlapping studies. The area of the grey boxes around a point estimate is proportional to the study’s weight in the meta-analysis. ICBP=International Consortium for Blood Pressure. CHARGE=Cohorts for Heart and Aging Research in Genomic Epidemiology. Global BPGen=Global Blood Pressure Genetics.
Figure 3
Figure 3. Mendelian randomisation triangulation for hypertension
Instrumental variable ratio calculation done with the natural log of the odds (βZY). OR=odds ratio. 25(OH)D=25-hydroxyvitamin D.

Comment in

References

    1. Autier P, Boniol M, Pizot C, Mullie P. Vitamin D status and ill health: a systematic review. Lancet Diabetes Endocrinol. 2014;2:76–89. - PubMed
    1. Bolland MJ, Grey A, Gamble GD, Reid IR. The effect of vitamin D supplementation on skeletal, vascular, or cancer outcomes: a trial sequential meta-analysis. Lancet Diabetes Endocrinol. 2014;2:307–20. - PubMed
    1. Tamez H, Thadhani RI. Vitamin D and hypertension: an update and review. Curr Opin Nephrol Hypertens. 2012;21:492–99. - PubMed
    1. Margolis KL, Ray RM, Van Horn L, et al. Effect of calcium and vitamin D supplementation on blood pressure: the Women’s Health Initiative randomized trial. Hypertension. 2008;52:847–55. - PMC - PubMed
    1. Witham MD, Nadir MA, Struthers AD. Effect of vitamin D on blood pressure: a systematic review and meta-analysis. J Hypertens. 2009;27:1948–54. - PubMed

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