Abstract 17209: Vitamin D Deficiency is Associated with Decreased Systolic Blood Pressure Reduction After Renal Sympathetic Denervation
Background: Vitamin D deficiency is associated with hypertension. However, it is unclear if vitamin D status influences therapeutic blood pressure reduction. Renal sympathetic denervation (RD) reduces blood pressure in patients with therapy resistant hypertension. We hypothesized that vitamin D status might influence blood pressure response to RD.
Patients and methods: Baseline vitamin D concentration was measured in 100 patients (mean age: 62 ± 1 years; 59% male) with therapy resistant hypertension who underwent RD. The association between vitamin D status and systolic blood pressure (SBP) reduction six months after RD was analyzed. Non-response was defined as reduction in SBP of 20 ng/ml). Mean office SBP at baseline was 171.5 ± 2 mmHg despite an intake of 5.3 ± 0.2 antihypertensive drugs. Six months after RD, mean office SBP was reduced by 28.4 ± 2.3 mmHg (p = 0.007). Out of the 100 enrolled patients, 84 patients (82 %) were responders. In the group of non-responders (n = 16, 18%), significantly more patients had a vitamin D concentration below the median compared to the group of responders (81 vs. 46%, p = 0.013). The percentage of patients with normal vitamin D concentration gradually increased with increasing tertiles of SBP reduction (tertile 1 (<18 mmHg): 6%; tertile 2 (18-34 mmHg): 19%; tertile 3 (>34 mmHg): 29%; p for trend = 0.02). Conversely, in patients with a vitamin D concentration below the median, SBP reduction was lower compared to patients with a vitamin D concentration above the median (23.46 ± 3.2 mmHg vs. 33.71 ± 3.2 mmHg, p = 0.026). Vitamin D concentration was lower in non-responders compared to responders (9.85 ± 4.5 ng/ml vs. 13.71 ± 7.35 ng/ml, p = 0.008). Furthermore, baseline vitamin D concentration showed a significant positive correlation to SBP reduction after 6 months (r = 0.202, p = 0.043).
Conclusion: In patients with therapy resistant hypertension undergoing RD, baseline vitamin D concentration below the median was associated with a decreased SBP reduction after six months and a higher rate of non-response compared to a vitamin D concentration above the median.
- © 2012 by American Heart Association, Inc.