Retrospective Evaluation of the Association Between Vitamin D Status and Blood Pressure Among Saudi Adolescents: A Five-Year Cohort Study
DOI:
https://doi.org/10.48047/CU/54/01/108-114Keywords:
Vitamin D deficiency, Blood pressure, Adolescents, Saudi Arabia, Retrospective Cohort, Cardiometabolic riskAbstract
Background: Vitamin D deficiency is prevalent among adolescents and may contribute to cardiometabolic risk factors, including elevated blood pressure. Limited evidence exists regarding this association in Saudi adolescents. Objective: To evaluate the association between vitamin D status and blood pressure in a retrospective cohort of Saudi adolescents.
Methods: We reviewed electronic health records of 1,960 adolescents (12–18 years) attending King Faisal University-affiliated medical centers from January 2019–September 2024. Serum 25(OH)D levels, anthropometrics, blood pressure readings, and metabolic parameters were extracted. Adolescents were categorized as vitamin D deficient (<30 nmol/L), insufficient (30–49 nmol/L), or sufficient (≥50 nmol/L). Multivariable linear and logistic regression analyses examined the relationship between vitamin D categories and blood pressure status, adjusting for age, sex, BMI, and metabolic factors.
Results: Vitamin D deficiency was observed in 42.4% of participants. Deficient adolescents had higher mean systolic and diastolic blood pressure and a greater prevalence of prehypertension/hypertension (27.1%) compared to sufficient peers (15.2%; p<0.001). Adjusted analyses revealed that vitamin D deficiency was associated with increased odds of elevated blood pressure (OR=1.58, 95% CI: 1.29–1.93, p<0.001). Sensitivity analyses stratified by BMI and sex produced consistent findings.
Conclusions: Vitamin D deficiency was independently associated with elevated blood pressure in Saudi adolescents. Addressing vitamin D deficiency may serve as an early preventive measure against the development of hypertension and its sequelae. Further prospective and interventional studies are warranted to guide clinical practice.
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References
Bell CS, Samuel JP, Samuels JA. Prevalence of hypertension in children: applying the new American Academy of Pediatrics clinical practice guideline. Hypertension. 2019;73:148–52.
Song P, Zhang Y, Yu J, Zha M, Zhu Y, Rahimi K, et al. Global prevalence of hypertension in children: a systematic review and meta-analysis. JAMA Pediatr. 2019;173:1154–63.
Falkner B. Hypertension in children and adolescents: epidemiology and natural history. Pediatr Nephrol. 2010;25:1219–24.
Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81.
Al-Daghri NM. Vitamin D in Saudi Arabia: prevalence, distribution and disease associations. J Steroid Biochem Mol Biol. 2018;175:102–7.
Al-Saleh Y, Al-Daghri NM, Khan N, Alfawaz H, Al-Othman AM, Alokail MS, Chrousos GP. Vitamin D status in Saudi school children based on knowledge. BMC Pediatr. 2015;15:53.
Al-Daghri NM, Al-Attas O, Alokail M, Alkharfy K, Yousef M, Nadhrah H, et al. Hypovitaminosis D and cardiometabolic risk factors among non-obese youth. Open Medicine. 2010;5:752–7.
Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122:398–417.
Palacios C, Gonzalez L. Is vitamin D deficiency a major global public health problem? J Steroid Biochem Mol Biol. 2014;144:138–45.
Holick MF, Chen TC. Vitamin D deficiency: a worldwide problem with health consequences. Am J Clin Nutr. 2008;87:1080S–6S.
Wortsman J, Matsuoka LY, Chen TC, Lu Z, Holick MF. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72:690–3.
Lee S, Kim SM, Park H, Choi KM, Cho GJ, Ko B, et al. Serum 25-hydroxyvitamin D levels, obesity and the metabolic syndrome among Korean children. Nutr Metab Cardiovasc Dis. 2013;23:785–91.
Ganji V, Zhang X, Shaikh N, Tangpricha V. Serum 25-hydroxyvitamin D concentrations are associated with prevalence of metabolic syndrome and various cardiometabolic risk factors in US children and adolescents. Am J Clin Nutr. 2011;94:225–33.
Kao KT, Abidi N, Ranasinha S, Brown J, Rodda C, McCallum Z, et al. Low vitamin D is associated with hypertension in paediatric obesity. J Paediatr Child Health. 2015;51:1207–13.
Norman AW. From vitamin D to hormone D: fundamentals of the vitamin D endocrine system essential for good health. Am J Clin Nutr. 2008;88:491S–9S.
Forman JP, Williams JS, Fisher ND. Plasma 25-hydroxyvitamin D and regulation of the renin-angiotensin system in humans. Hypertension. 2010;55:1283–9.
Sugden JA, Davies JI, Witham MD, Morris A, Struthers AD. Vitamin D improves endothelial function in patients with type 2 diabetes mellitus and low vitamin D levels. Diabet Med. 2008;25:320–5.
Tarcin O, Yavuz DG, Ozben B, Telli A, Ogunc A, Yuksel M, et al. Effect of vitamin D deficiency and replacement on endothelial function in asymptomatic subjects. J Clin Endocrinol Metab. 2009;94:4023–31.
Abboud M. Vitamin D supplementation and blood pressure in children and adolescents: a systematic review and meta-analysis. Nutrients. 2020;12(4):1163.
Hauger H, Laursen RP, Ritz C, Mølgaard C, Lind MV, Damsgaard CT. Effects of vitamin D supplementation on cardiometabolic outcomes in children and adolescents: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr. 2020;12(4):1163.
Beveridge LA, Struthers AD, Khan F, Jorde R, Scragg R, Macdonald HM, et al. Effect of vitamin D supplementation on blood pressure: a systematic review and meta-analysis incorporating individual patient data. JAMA Intern Med. 2015;175:745–54.
Pittas AG, Chung M, Trikalinos T, Mitri J, Brendel M, Pate K, et al. Vitamin D and cardiometabolic outcomes: a systematic review. Ann Intern Med. 2010;152:307–14.
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