Vitamin D in children with primary hypertension

Abstract

Introduction: Recent evidence suggests that vitamin D plays a role in pathogenesis of arterial hypertension. The aim was to assess vitamin D in children and adolescents with arterial hypertension. Material and methods: In 49 children (14.29 ± 3.17 years) with arterial hypertension we evaluated vitamin D status (according to Polish 2018 Guidelines), serum calcium, phosphorus, parathormone, alkaline phosphatase, office blood pressure, ABPM (including ambulatory arterial stiffness index [AASI]), BMI, GFR, uric acid, lipids and albuminuria. None of the children were supplemented with vitamin D. Results: Mean vitamin D concentration was 19.74 ± 9.68 ng/mL. Vitamin D severe deficiency (0-10 ng/mL) was found in 5 (10.2%), deficiency (> 10-20 ng/mL) in 29 (49.0%), suboptimal concentration (> 20-30 ng/mL) in 17 (34.7%), optimal concentration (> 30 to 50 ng/mL) in 1 (2.0%), and high concentration (> 50 to 100 ng/mL) in 2 (4.1%) children. Vitamin D was higher in spring-summer vs. autumn-winter (21.79 ± 10.19 vs. 15.53 ± 7.08 ng/mL, p = 0.03). Vitamin D correlated with height Z-score (r = 0.39, p < 0.01), BMI Z-score (r = -0.34, p = 0.02), uric acid (r = -0.31, p = 0.04), triglycerides (r = -0.37, p = 0.01), but not with office blood pressure and ABPM parameters except for heart rate (r = -0.38, p < 0.01). In 24 children treated with antihypertensive medications vitamin D correlated with AASI (r = 0.50, p = 0.04). Conclusions: 1. Inadequate vitamin D supply is ubiquitous in children with arterial hypertension. 2. Vitamin D deficiency should be suspected especially in autumn-winter period and among obese and short children. 3. The relation between vitamin D status and ambulatory arterial stiffness index suggests negative influence of vitamin D on arterial wall but requires further investigations.