Low Levels of 25-hydroxyvitamin D in the Pediatric Populations: Prevalence and Clinical Outcomes

Michal L Melamed; Juhi Kumar

Pediatr Health. 2010;4(1):89-97.

Vitamin D & High Blood Pressure

The antihypertensive actions of vitamin D are thought to be the result of suppression of the renin–angiotensin–aldosterone system,^[51–53] direct effects on vascular cells,^[54,55] effects on calcium metabolism^[56] and the prevention of secondary hyperparathyroidism.^[57–59] The VDR-knockout mouse develops hypertension.^[51]

There have been few studies in children that have evaluated the association between 25(OH)D levels and blood pressure. Smotkin-Tangorra et al. evaluated 25(OH)D levels in 217 obese children and found higher systolic blood pressure in those with levels below 20 ng/ml.^[10] This study had only obese children and it is possible that obesity could be a potential confounding factor in determining the effects of low 25(OH)D levels on hypertension. Reis et al. performed a cross-sectional analysis of 3577 adolescents who participated in the 2001–2004 NHANES.^[60] They found an adjusted odds ratio of 2.36 (1.33–4.19) for those in the lowest (<15 ng/ml) compared with the highest quartile (>26 ng/ml) of 25(OH)D for hypertension. Our analysis of data from children and adolescents aged 1–21 years using the NHANES 2001–2004 database found significantly higher prevalence of hypertension and higher systolic and diastolic blood pressures in the vitamin D-deficient (<15 ng/ml) group. 25(OH)D deficiency was associated with higher systolic blood pressure (OR: 2.24 mmHg [0.98–3.50mmHg]). Hypertension was 2.5-times more likely in the vitamin D-deficient (<15 ng/ml) group when compared with those with levels above 30 ng/ml.^[15]

All the above pediatric studies are cross-sectional analyses, hence they only highlight associations and do not prove causality. Randomized, controlled trials of vitamin D supplementation and its long-term effects on blood pressure in children need to be undertaken to evaluate the effects of vitamin D on blood pressure.

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Cite this: Low Levels of 25-hydroxyvitamin D in the Pediatric Populations: Prevalence and Clinical Outcomes - Medscape - Feb 01, 2010.

Abstract and Introduction
Vitamin D Metabolism & Sources of Vitamin D
Prevalence of Vitamin D Deficiency
Risk Factors for Vitamin D Deficiency
Vitamin D & Rickets
Vitamin D & Bone Mineral Density
Vitamin D & High Blood Pressure
Vitamin D & Diabetes Mellitus
Vitamin D & Lipid Abnormalities
Conclusion
Future Perspective
References
Sidebar

Box 1. Common risk factors for vitamin D (25[OH]D) deficiency.
*Non-modifiable risk factors* Age Female sex^[15] Non-white race Non-white race Antiepileptic therapy^[102] Malabsorption (inflammatory bowel disease and cystic fibrosis) Burns *Modifiable risk factors* Obesity Less milk drinking Not taking vitamin D supplements Less outdoor physical activity Exclusive breast-feeding Sunscreen use Clothing *Non-patient factors* Higher latitude Season of year Lower altitude More cloud cover

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