Vitamin D status and its correlation with blood pressure in premenopausal Saudi women: a cross-sectional study.

Sarah Al Mazeedi, Hanan Al Kadi, Mohammed Ardawi


Vitamin D deficiency is a major health problem in the Saudi population. A negative association between blood pressure and vitamin D level has been suggested in several clinical and epidemiological studies and evidence for an effect of vitamin D in lowering blood pressure was reported. These findings indicate that 1,25(OH)2D3 deficiency may play a role in the pathogenesis of hypertension through its effect on the renin-angiotensin system. We are the first to investigate the correlation between blood pressure or renin concentration and vitamin D status in the Saudi population METHODS: we included 201 healthy Saudi premenopausal females (20-45 years old). Blood pressure was measured by a standardized method using an automated blood pressure monitor (BPTru). Fasting blood samples were collected from each participant after 20 minutes of rest in the seated position. Serum cholicalciferol, PTH and renin concentration were measured by sandwich chemiluminescence immunoassaymethod (DiaSorin, Italy). RESULTS: The analysis included 192 subjects who were normotensive (blood pressure <140/90 mmHg).  A total of  34% of women had a severe deficiency (vitamin D ≤ 12.5 nmol/L); 41% had moderate deficiency (vitamin D levels between 12.5 - 25 nmol/L);  23% had mild deficiency (vitamin D level ≥ 25 - < 50 nmol/L); and 2% had insufficiency (vitamin D level  ≥ 50 - ≤ 75 nmol/L). None had a sufficient level of ≥75 nmol/L.  The systolic blood pressure ranged from 79-130.5mmHg and the diastolic from 48.5-85.5 mmHg.  Both systolic and diastolic blood pressures were significantly higher in women that were in the lower 2 quartiles of vitamin D.  However, linear regression analysis adjusting for potential confounders showed that 25(OH)D level was not a predictor of either systolic or diastolic blood pressures.  A negative correlation (although not significant) was found between vitamin D level and plasma renin concentration in this study group. CONCLUSION: Vitamin D deficiency was highly prevalent among the study group. Vitamin D was a not a predictor of either systolic or diastolic blood pressure.  There was a negative correlation between vitamin D level and renin concentration although not statically significant. It is possible that any underlying relationship was obscured by the relatively young age group or due to the narrow blood pressure range of the studied population. A larger sample size including hypertensive subjects may be needed.


Vitamin D, Blood pressure, Renin hormone

Full Text:



Al-Nozha, M. M., Abdullah, M., Arafah, M. R., Khalil, M. Z., Khan, N. B., Al-Mazrou, Y. Y., Al-Maatouq, M. A., Al-Marzouki, K., Al-Khadra, A., Nouh, M. S., Al-Harthi, S. S., Al-Shahid, M. S. & Al-Mobeireek, A. (2007) Hypertension in Saudi Arabia. Saudi Med J, vol. 28: 77-84.

Al-Turki, H. A., Sadat-Ali, M., Al-Elq, A. H., Al-Mulhim, F. A. & Al-Ali, A. K. (2008) 25-Hydoxyvitamin D levels among healthy Saudi Arabian women. Saudi Med J, vol. 29: 1765-1768.

Ardawi, M. S., Maimany, A. A., Bahksh, T. M., Nasrat, H. A., Milaat, W. A. & Al-Raddadi, R. M. (2005) Bone mineral density of the spine and femur in healthy Saudis. Osteoporos Int, vol. 16: 43-55.

Ardawi, M. S., Qari, M. H., Rouzi, A. A., Maimani, A. A. & Raddadi, R. M. (2011) Vitamin D status in relation to obesity, bone mineral density, bone turnover markers and vitamin D receptor genotypes in healthy Saudi pre- and postmenopausal women. Osteoporos Int, vol. 22: 463-475.

British heart society (2001) Blood Pressure Measurment With Electronic Blood Pressure Monitor.

Deluca, H. F. (2004) Overview of general physiologic features and functions of vitamin D. American Journal of Clinical nutrition vol. 80: 1689–1696.

Forman, J. P., Bischoff-Ferrari, H. A., Willett, W. C., Stampfer, M. J. & Curhan, G. C. (2005) Vitamin D intake and risk of incident hypertension: results from three large prospective cohort studies. Hypertension, vol. 46: 676-682.

Forman, J. P., Williams, J. S. & Fisher, N. D. (2011) Plasma 25-hydroxyvitamin D and regulation of the renin-angiotensin system in humans. Hypertension, vol. 55: 1283-1288.

Gannage-Yared, M. H., Chedid, R., Khalife, S., Azzi, E., Zoghbi, F. & Halaby, G. (2009) Vitamin D in relation to metabolic risk factors, insulin sensitivity and adiponectin in a young Middle-Eastern population. Eur J Endocrinol, vol. 160: 965-971.

Holick, M. (2009) Vitamin D and Health: Evolution, Biologic Functions, and Recommended Dietary Intakes for Vitamin D. Clinic Rev Bone Miner Metab vol. 7: 2–19.

Holick, M. (2010) Vitamin D: Physiology, Molecular Biology, and Clinical Applications, 2, New York: Human Press.

Kimura, Y., Kawamura, M., Owada, M., Oshima, T., Murooka, M., Fujiwara, T. & Hiramori, K. (1999) Effectiveness of 1,25-dihydroxyvitamin D supplementation on blood pressure reduction in a pseudohypoparathyroidism patient with high renin activity. Intern Med, vol. 38: 31-35.

Krause, R., Buhring, M., Hopfenmuller, W., Holick, M. F. & Sharma, A. M. (1998) Ultraviolet B and blood pressure. Lancet, vol. 352: 709-710.

Li, Y. C., Qiao, G., Uskokovic, M., Xiang, W., Zheng, W. & Kong, J. (2004) Vitamin D: a negative endocrine regulator of the renin-angiotensin system and blood pressure. J Steroid Biochem Mol Biol, vol. 89-90: 387-392.

Margolis, K. L., Ray, R. M., Van Horn, L., Manson, J. E., Allison, M. A., Black, H. R., Beresford, S. A., Connelly, S. A., Curb, J. D., Grimm, R. H., Jr., Kotchen, T. A., Kuller, L. H., Wassertheil-Smoller, S., Thomson, C. A. & Torner, J. C. (2008) Effect of calcium and vitamin D supplementation on blood pressure: the Women's Health Initiative Randomized Trial. Hypertension, vol. 52: 847-855.

Mattu, G. S., Perry, T. L., Jr. & Wright, J. M. (2001) Comparison of the oscillometric blood pressure monitor (BPM-100(Beta) ) with the auscultatory mercury sphygmomanometer. Blood Press Monit, vol. 6: 153-159.

NhLbi obesity education initiative. (2000) The Practical Guide Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, NIH Publication.

Peterlik, M. & Cross, H. S. (2009) Vitamin D and calcium insufficiency-related chronic diseases: molecular and cellular pathophysiology. Eur J Clin Nutr, vol. 63: 1377-1386.

Pfeifer, M., Begerow, B., Minne, H. W., Nachtigall, D. & Hansen, C. (2001) Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women. J Clin Endocrinol Metab, vol. 86: 1633-1637.

Saeed, A. A., Al-Hamdan, N. A., Bahnassy, A. A., Abdalla, A. M., Abbas, M. A. & Abuzaid, L. Z. (2011) Prevalence, Awareness, Treatment, and Control of Hypertension among Saudi Adult Population: A National Survey. Int J Hypertens, vol. 2011: 174135.

Sugden, J. A., Davies, J. I., Witham, M. D., Morris, A. D. & Struthers, A. D. (2008) Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabet Med, vol. 25: 320-325.

Wortsman, J., Matsuoka, L. Y., Chen, T. C., Lu, Z. & Holick, M. F. (2000) Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr, vol. 72: 690-693.

Yuan, W., Pan, W., Kong, J., Zheng, W., Szeto, F. L., Wong, K. E., Cohen, R., Klopot, A., Zhang, Z. & Li, Y. C. (2007) 1,25-dihydroxyvitamin D3 suppresses renin gene transcription by blocking the activity of the cyclic AMP response element in the renin gene promoter. J Biol Chem, vol. 282: 29821-29830.



  • There are currently no refbacks.

Print ISSN 1804-5804, Online ISSN 1804-9702

(c) 2018 CBU,o.p.s.