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de Queiroz NNM, de Melo FTC, de Souza Resende F, Janaú LC, de Souza Neto NJK, de Lemos MN, de Oliveira MCNI, de Alcântara AL, de Moraes LV, da Mota Queiroz A, de Souza ÍJA, Said NM, Dos Santos MC, de Souza D'Albuquerque Silva L, Motta ARB, de Sá Oliveira Dos Reis M, Lobato IJC, de Figueiredo PBB, de Souza ACCB, Freire Piani PP, Felício KM, Abrahão Neto JF, Felício JS. High-dose Cholecalciferol Supplementation Reducing Morning Blood Pressure in Normotensive DM1 Patients. Curr Diabetes Rev 2021; 17:378-386. [PMID: 32729423 DOI: 10.2174/1573399816999200729131508] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/09/2020] [Accepted: 07/15/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Vitamin D (VD) deficiency has been related to several endocrine metabolic and cardiovascular diseases. The effect of VD supplementation on blood pressure (BP) in patients with diabetes is controversial. OBJECTIVE The aim of this study was to evaluate high-dose vitamin D supplementation effects on blood pressure of normotensive patients with diabetes mellitus 1 (DM1) patients by 24-hour ambulatory blood pressure monitoring (ABPM). METHODS We performed a clinical trial including 35 DM1 normotensive patients, who received doses of 4,000 or 10,000 IU/day of cholecalciferol for 12 weeks according to previous VD levels. They underwent 24-hour ABPM, along with glycated hemoglobin, creatine, lipids profile and PCRus dosage before and after VD supplementation. RESULTS We found an expressive reduction of systolic and diastolic morning blood pressures (117±14 vs 112±14, p<0,05; 74±9 vs 70±10 mmHg, p<0,05, respectively) with no changes in other pressoric markers. Besides, we noticed a relationship between levels of VD after supplementation and diastolic morning blood pressure (r= -0,4; p<0.05). CONCLUSION Our study suggests an association between supplementation of high doses of vitamin D and the reduction of morning blood pressure in normotensive DM1 patients.
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Affiliation(s)
- Natércia Neves Marques de Queiroz
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Franciane Trindade Cunha de Melo
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Fabrício de Souza Resende
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Luísa Corrêa Janaú
- State University of Para, Platter Perebebui, 2623, Marco, Belem 66087-662, Para, Brazil
| | - Norberto Jorge Kzan de Souza Neto
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Manuela Nascimento de Lemos
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Maria Clara Neres Iunes de Oliveira
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Angélica Leite de Alcântara
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Lorena Vilhena de Moraes
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Apolone da Mota Queiroz
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Ícaro José Araújo de Souza
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Nivin Mazen Said
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Márcia Costa Dos Santos
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Lilian de Souza D'Albuquerque Silva
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Ana Regina Bastos Motta
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Melissa de Sá Oliveira Dos Reis
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Isabel Jane Campos Lobato
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | | | - Ana Carolina Contente Braga de Souza
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Pedro Paulo Freire Piani
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - Karem Miléo Felício
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - João Felício Abrahão Neto
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
| | - João Soares Felício
- Endocrinology Division, University Hospital Joao de Barros Barreto, Federal University of Para, Mundurucus Street, 4487, Guama, Belem 66073-000, Para, Brazil
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Shimizu H, Hoshide S, Kanegae H, Kario K. Cardiovascular outcome and home blood pressure in relation to silent myocardial ischemia in a clinical population: The J-HOP study. J Clin Hypertens (Greenwich) 2020; 22:2214-2220. [PMID: 33086426 DOI: 10.1111/jch.14076] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 09/17/2020] [Accepted: 09/19/2020] [Indexed: 12/27/2022]
Abstract
Several guidelines recommend measuring home blood pressure (BP) and lowering blood pressure than ever before. But several studies reported that lowering diastolic blood pressure (DBP) increased the incidence of coronary artery disease (CAD). We analyzed 3605 individuals who underwent both home and office BP monitoring over 14 days and baseline Hs-cTnT measurement and identified follow-up data of the Japan Morning Surge-Home Blood Pressure (J-HOP) study who had a history of or risk factors for cardiovascular disease. During a mean follow-up period of 6.4 years (23 173 person-years), 114 coronary artery disease and 81 stroke events occurred. Elevated Hs-cTnT (≥0.014 ng/mL) was observed in 298 patients (8.3%). In the group with non-elevated Hs-cTnT (<0.014 ng/mL, n = 3307), an adjusted Cox hazard model showed that home systolic BP (SBP) was associated with a risk of stroke incidence (hazard ratio [HR] per 1 SD, 1.62; 95% confidence interval [CI], 1.29-2.03). This association was also observed in office SBP (HR per 1 SD, 1.43; 95%CI, 1.07-1.91). There was no association between office or home BP and CAD events in the group with non-elevated Hs-cTnT. In the group with elevated Hs-cTnT, an adjusted Cox hazard model showed that home DBP was associated with a risk of CAD incidence (HR per 1 SD, 0.54; 95%CI, 0.30-0.99). However, this association was not observed in office DBP. In patients with elevated Hs-cTnT, which is a marker of subclinical myocardial ischemia, excessive lowering of home DBP may be associated with a risk of incident CAD.
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Affiliation(s)
- Hayato Shimizu
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | | | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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