Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Age and sex differences in the relationship between serum 25-hydroxyvitamin D and hypertension in the general Korean population

Abstract

Background/Objectives:

Previous studies have suggested that serum 25-hydroxyvitamin D (25(OH)D) is associated with hypertension. However, the effects of age and sex on the relation between serum 25(OH)D and hypertension has not been examined. The present study examined the relationship between serum 25(OH)D and hypertension by age and sex in the general Korean population, considering potential confounders for hypertension.

Subjects/Methods:

We conducted a population-based, cross-sectional study. Twenty thousand four hundred and forty adults aged 19 years or older, who participated in the 2009–2012 Korean National Health and Nutrition Examination Surveys, were selected for the present study. Hypertension was defined as a systolic blood pressure 140 mm Hg, diastolic blood pressure 90 mm Hg or current use of antihypertensive medication.

Results:

We found that serum 25(OH)D levels are inversely associated with hypertension in young and middle-aged adults, but not in the elderly population. In young and middle-aged adults, the adjusted odds ratios (ORs) for hypertension tended to decrease according to the quartiles of serum 25(OH)D after adjustment for potential confounders, although it was only significant in women (OR=0.73, 95% confidence interval (CI)=0.58–0.91, P for trend=0.0349). There was no association between serum 25(OH)D concentration and hypertension in elderly subjects of either sex.

Conclusions:

A higher serum 25(OH)D level was strongly associated with a lower prevalence of hypertension in young and middle-aged Korean women, but not in elderly adults.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Lips P . Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev 2001; 22: 477–501.

    Article  CAS  Google Scholar 

  2. DeLuca HF . The vitamin D story: a collaborative effort of basic science and clinical medicine. FASEB J 1988; 2: 224–236.

    Article  CAS  Google Scholar 

  3. Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Arch Intern Med 2007; 167: 1159–1165.

    Article  CAS  Google Scholar 

  4. Forman JP, Giovannucci E, Holmes MD, Bischoff-Ferrari HA, Tworoger SS, Willett WC et al. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension 2007; 49: 1063–1069.

    Article  CAS  Google Scholar 

  5. Chan R, Chan D, Woo J, Ohlsson C, Mellstrom D, Kwok T et al. Serum 25-hydroxyvitamin D and parathyroid hormone levels in relation to blood pressure in a cross-sectional study in older Chinese men. J Hum Hypertens 2012; 26: 20–27.

    Article  CAS  Google Scholar 

  6. Snijder MB, Lips P, Seidell JC, Visser M, Deeg DJ, Dekker JM et al. Vitamin D status and parathyroid hormone levels in relation to blood pressure: a population-based study in older men and women. J Intern Med 2007; 261: 558–565.

    Article  CAS  Google Scholar 

  7. Scragg R, Sowers M, Bell C . Serum 25-hydroxyvitamin D, ethnicity, and blood pressure in the Third National Health and Nutrition Examination Survey. Am J Hypertens 2007; 20: 713–719.

    Article  CAS  Google Scholar 

  8. Bolivar JJ . Essential hypertension: an approach to its etiology and neurogenic pathophysiology. Int J Hypertens 2013; 2013: 547809.

    Article  Google Scholar 

  9. Fu M . Hypertension in the elderly: where are we? Int J Cardiol 2012; 155: 6–8.

    Article  Google Scholar 

  10. The American Society of Hypertension. Recommendations for routine blood pressure measurement by indirect cuff sphygmomanometry. American Society of Hypertension. Am J Hypertens 1992; 5: 207–209.

    Article  Google Scholar 

  11. Kim J . Association between serum vitamin D, parathyroid hormone and metabolic syndrome in middle-aged and older Korean adults. Eur J Clin Nutr 2015; 69: 425–430.

    Article  CAS  Google Scholar 

  12. Zittermann A, Frisch S, Berthold HK, Gotting C, Kuhn J, Kleesiek K et al. Vitamin D supplementation enhances the beneficial effects of weight loss on cardiovascular disease risk markers. Am J Clin Nutr 2009; 89: 1321–1327.

    Article  CAS  Google Scholar 

  13. Korean Nutrition Society Dietary Reference Intake for Korean. Kookjin Press: Seoul: Republic of Korea, 2005.

  14. Willett WC, Howe GR, Kushi LH . Adjustment for total energy intake in epidemiologic studies. Am J Clin Nutr 1997; 65: 1220S–1228S. discussion; 1229S-1231S.

    Article  CAS  Google Scholar 

  15. Forman JP, Curhan GC, Taylor EN . Plasma 25-hydroxyvitamin D levels and risk of incident hypertension among young women. Hypertension 2008; 52: 828–832.

    Article  CAS  Google Scholar 

  16. Toxqui L, Blanco-Rojo R, Wright I, Perez-Granados AM, Vaquero MP . Changes in blood pressure and lipid levels in young women consuming a vitamin D-fortified skimmed milk: a randomised controlled trial. Nutrients 2013; 5: 4966–4977.

    Article  CAS  Google Scholar 

  17. Scragg R, Khaw KT, Murphy S . Effect of winter oral vitamin D3 supplementation on cardiovascular risk factors in elderly adults. Eur J Clin Nutr 1995; 49: 640–646.

    CAS  PubMed  Google Scholar 

  18. Tomaschitz A, Pilz S, Ritz E, Grammer T, Drechsler C, Boehm BO et al. Independent association between 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D and the renin-angiotensin system: the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. Clin Chim Acta 2010; 411: 1354–1360.

    Article  CAS  Google Scholar 

  19. Martini LA, Wood RJ . Vitamin D and blood pressure connection: update on epidemiologic, clinical, and mechanistic evidence. Nutr Rev 2008; 66: 291–297.

    Article  Google Scholar 

  20. Li YC . Vitamin D regulation of the renin-angiotensin system. J Cell Biochem 2003; 88: 327–331.

    Article  CAS  Google Scholar 

  21. Borissova AM, Tankova T, Kirilov G, Dakovska L, Kovacheva R . The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients. Int J Clin Pract 2003; 57: 258–261.

    CAS  PubMed  Google Scholar 

  22. Chiu KC, Chu A, Go VL, Saad MF . Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 2004; 79: 820–825.

    Article  CAS  Google Scholar 

  23. Pfeifer M, Begerow B, Minne HW, Nachtigall D, Hansen C . Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab 2001; 86: 1633–1637.

    CAS  PubMed  Google Scholar 

  24. van Ballegooijen AJ, Kestenbaum B, Sachs MC, de Boer IH, Siscovick DS, Hoofnagle AN et al. Association of 25-hydroxyvitamin D and parathyroid hormone with incident hypertension: MESA (Multi-Ethnic Study of Atherosclerosis). J Am Coll Cardiol 2014; 63: 1214–1222.

    Article  CAS  Google Scholar 

  25. Lakatta EG . Central arterial aging and the epidemic of systolic hypertension and atherosclerosis. J Am Soc Hypertens 2007; 1: 302–340.

    Article  Google Scholar 

  26. Mitchell GF . Arterial stiffness and hypertension: chicken or egg? Hypertension 2014; 64: 210–214.

    Article  CAS  Google Scholar 

  27. Franklin SS, Jacobs MJ, Wong ND, L'Italien GJ, Lapuerta P . Predominance of isolated systolic hypertension among middle-aged and elderly US hypertensives: analysis based on National Health and Nutrition Examination Survey (NHANES) III. Hypertension 2001; 37: 869–874.

    Article  CAS  Google Scholar 

  28. Dernellis J, Panaretou M . Aortic stiffness is an independent predictor of progression to hypertension in nonhypertensive subjects. Hypertension 2005; 45: 426–431.

    Article  CAS  Google Scholar 

  29. Liao D, Arnett DK, Tyroler HA, Riley WA, Chambless LE, Szklo M et al. Arterial stiffness and the development of hypertension. The ARIC study. Hypertension 1999; 34: 201–206.

    Article  CAS  Google Scholar 

  30. Takase H, Dohi Y, Toriyama T, Okado T, Tanaka S, Sonoda H et al. Brachial-ankle pulse wave velocity predicts increase in blood pressure and onset of hypertension. Am J Hypertens 2011; 24: 667–673.

    Article  Google Scholar 

  31. Kaess BM, Rong J, Larson MG, Hamburg NM, Vita JA, Levy D et al. Aortic stiffness, blood pressure progression, and incident hypertension. JAMA 2012; 308: 875–881.

    Article  CAS  Google Scholar 

  32. Najjar SS, Scuteri A, Shetty V, Wright JG, Muller DC, Fleg JL et al. Pulse wave velocity is an independent predictor of the longitudinal increase in systolic blood pressure and of incident hypertension in the Baltimore Longitudinal Study of Aging. J Am Coll Cardiol 2008; 51: 1377–1383.

    Article  Google Scholar 

  33. Vanhoutte PM . Endothelium and control of vascular function. State of the Art lecture. Hypertension 1989; 13: 658–667.

    Article  CAS  Google Scholar 

  34. Versari D, Daghini E, Virdis A, Ghiadoni L, Taddei S . Endothelium-dependent contractions and endothelial dysfunction in human hypertension. Br J Pharmacol 2009; 157: 527–536.

    Article  CAS  Google Scholar 

  35. Rossi R, Chiurlia E, Nuzzo A, Cioni E, Origliani G, Modena MG . Flow-mediated vasodilation and the risk of developing hypertension in healthy postmenopausal women. J Am Coll Cardiol 2004; 44: 1636–1640.

    Article  Google Scholar 

  36. Balan H, Popescu L . “Gender specific medicine”: a focus on gender-differences in hypertension. Rom J Intern Med 2014; 52: 129–141.

    CAS  PubMed  Google Scholar 

  37. Pechere-Bertschi A, Burnier M . Female sex hormones, salt, and blood pressure regulation. Am J Hypertens 2004; 17: 994–1001.

    Article  CAS  Google Scholar 

  38. Verdoia M, Schaffer A, Barbieri L, Di Giovine G, Marino P, Suryapranata H et alNovara Atherosclerosis Study G. Impact of gender difference on vitamin D status and its relationship with the extent of coronary artery disease. Nutr Metab Cardiovasc Dis 2015; 25: 464–470.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This research was supported by the Basic Science Research Program of the National Research Foundation of Korea (NRF) founded by the Ministry of Education, Science and Technology (NRF2012R1A1A1012317).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J Kim.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, D., Kim, J. Age and sex differences in the relationship between serum 25-hydroxyvitamin D and hypertension in the general Korean population. Eur J Clin Nutr 70, 326–332 (2016). https://doi.org/10.1038/ejcn.2015.115

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2015.115

This article is cited by

Search

Quick links