Racial disparity in blood pressure: Is vitamin D a factor?

Kevin Fiscella, Paul Winters, Daniel J Tancredi, Peter Franks

Research output: Contribution to journalArticle

23 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)1105-1111
Number of pages7
JournalJournal of General Internal Medicine
Volume26
Issue number10
DOIs
StatePublished - 2011

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Vitamin D
Blood Pressure
Cross-Sectional Studies
Nutrition Surveys
Health Behavior
Social Support
African Americans
Antihypertensive Agents
Health Status
Adipose Tissue
Randomized Controlled Trials
Biomarkers
Demography
hydroquinone
Exercise
Hypertension
Morbidity
Delivery of Health Care
Skin
Mortality

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 journalArticle

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