Abstract
Background: Higher prevalence of hypertension among African Americans is a key cause of racial disparity in cardiovascular morbidity and mortality. Explanations for the difference in prevalence are incomplete. Emerging data suggest that low vitamin D levels may contribute. Objective: To assess the contribution of vitamin D to racial disparity in blood pressure. Design: Cross-sectional analysis. Participants: Adult non-Hispanic Black and White participants from the National Health and Nutrition Examination Survey 2001-2006. Measures: We assessed Black-White differences in systolic blood pressure (SBP) controlling for conventional risk factors, and then additionally, for vitamin D (serum 25[OH]D). Results: The sample included 1984 and 5156 Black and White participants ages 20 years and older. The mean age-sex adjusted Black-White SBP difference was 5.2 mm Hg. This difference was reduced to 4.0 mm Hg with additional adjustment for socio-demographic characteristics, health status, health care, health behaviors, and biomarkers; adding 25(OH)D reduced the race difference by 26% (95% CI 7-46%) to 2.9 mm Hg. This effect increased to 39% (95% CI 14-65%) when those on antihypertensive medications were excluded. Supplementary analyses that controlled for cardiovascular fitness, percent body fat, physical activity monitoring, skin type and social support yielded consistent results. Conclusion: In cross-sectional analyses, 25(OH)D explains one quarter of the Black-White disparity in SBP. Randomized controlled trials are required to determine whether vitamin D supplementation could reduce racial disparity in BP.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1105-1111 |
| Number of pages | 7 |
| Journal | Journal of General Internal Medicine |
| Volume | 26 |
| Issue number | 10 |
| DOIs | |
| State | Published - 2011 |
Fingerprint
Keywords
- African continental ancestry
- blood pressure
- vitamin D
ASJC Scopus subject areas
- Internal Medicine
Cite this
Racial disparity in blood pressure : Is vitamin D a factor? / Fiscella, Kevin; Winters, Paul; Tancredi, Daniel J; Franks, Peter.
In: Journal of General Internal Medicine, Vol. 26, No. 10, 2011, p. 1105-1111.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Racial disparity in blood pressure
T2 - Is vitamin D a factor?
AU - Fiscella, Kevin
AU - Winters, Paul
AU - Tancredi, Daniel J
AU - Franks, Peter
PY - 2011
Y1 - 2011
N2 - Background: Higher prevalence of hypertension among African Americans is a key cause of racial disparity in cardiovascular morbidity and mortality. Explanations for the difference in prevalence are incomplete. Emerging data suggest that low vitamin D levels may contribute. Objective: To assess the contribution of vitamin D to racial disparity in blood pressure. Design: Cross-sectional analysis. Participants: Adult non-Hispanic Black and White participants from the National Health and Nutrition Examination Survey 2001-2006. Measures: We assessed Black-White differences in systolic blood pressure (SBP) controlling for conventional risk factors, and then additionally, for vitamin D (serum 25[OH]D). Results: The sample included 1984 and 5156 Black and White participants ages 20 years and older. The mean age-sex adjusted Black-White SBP difference was 5.2 mm Hg. This difference was reduced to 4.0 mm Hg with additional adjustment for socio-demographic characteristics, health status, health care, health behaviors, and biomarkers; adding 25(OH)D reduced the race difference by 26% (95% CI 7-46%) to 2.9 mm Hg. This effect increased to 39% (95% CI 14-65%) when those on antihypertensive medications were excluded. Supplementary analyses that controlled for cardiovascular fitness, percent body fat, physical activity monitoring, skin type and social support yielded consistent results. Conclusion: In cross-sectional analyses, 25(OH)D explains one quarter of the Black-White disparity in SBP. Randomized controlled trials are required to determine whether vitamin D supplementation could reduce racial disparity in BP.
AB - Background: Higher prevalence of hypertension among African Americans is a key cause of racial disparity in cardiovascular morbidity and mortality. Explanations for the difference in prevalence are incomplete. Emerging data suggest that low vitamin D levels may contribute. Objective: To assess the contribution of vitamin D to racial disparity in blood pressure. Design: Cross-sectional analysis. Participants: Adult non-Hispanic Black and White participants from the National Health and Nutrition Examination Survey 2001-2006. Measures: We assessed Black-White differences in systolic blood pressure (SBP) controlling for conventional risk factors, and then additionally, for vitamin D (serum 25[OH]D). Results: The sample included 1984 and 5156 Black and White participants ages 20 years and older. The mean age-sex adjusted Black-White SBP difference was 5.2 mm Hg. This difference was reduced to 4.0 mm Hg with additional adjustment for socio-demographic characteristics, health status, health care, health behaviors, and biomarkers; adding 25(OH)D reduced the race difference by 26% (95% CI 7-46%) to 2.9 mm Hg. This effect increased to 39% (95% CI 14-65%) when those on antihypertensive medications were excluded. Supplementary analyses that controlled for cardiovascular fitness, percent body fat, physical activity monitoring, skin type and social support yielded consistent results. Conclusion: In cross-sectional analyses, 25(OH)D explains one quarter of the Black-White disparity in SBP. Randomized controlled trials are required to determine whether vitamin D supplementation could reduce racial disparity in BP.
KW - African continental ancestry
KW - blood pressure
KW - vitamin D
UR - http://www.scopus.com/inward/record.url?scp=85027937215&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85027937215&partnerID=8YFLogxK
U2 - 10.1007/s11606-011-1707-8
DO - 10.1007/s11606-011-1707-8
M3 - Article
AN - SCOPUS:85027937215
VL - 26
SP - 1105
EP - 1111
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
SN - 0884-8734
IS - 10
ER -