Authors : Dr. Evuri Pramod Reddy; Dr. Gunna Giridhar Reddy; Dr. Shaik Fathima

Volume/Issue : Volume 11 - 2026, Issue 5 - May

Google Scholar : https://tinyurl.com/3kabzjwu

Scribd : https://tinyurl.com/y2r6j2wb

DOI : https://doi.org/10.38124/ijisrt/26May2107

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Aim: To study association between vit D levels among Hypertension patients Attending a tertiary care hospital.  Background and Objectives : Previous studies have suggested that individuals with low vitamin D levels are more likely to develop hypertension. Vitamin D deficiency may increase blood pressure through activation of the renin–angiotensin–aldosterone system, impaired vasodilation, increased vascular stiffness, and altered calcium metabolism. However, evidence regarding this association remains inconsistent, especially in the Indian population where vitamin D deficiency is common despite adequate sunlight exposure.  Materials and Methods A cross-sectional study was conducted in the Department of General Medicine, Katuri Medical College and Hospital, Guntur, over a period of two years. A total of 100 adults with primary hypertension were included. Patients above 18 years who provided informed consent were enrolled, while those with chronic kidney disease, chronic liver disease, or on vitamin D/calcium supplements were excluded. Blood pressure was recorded according to JNC-8 criteria, and serum vitamin D levels were measured. The collected data were statistically analyzed to assess the association between vitamin D levels and blood pressure.  Results The study included 100 patients diagnosed with primary hypertension. Most participants belonged to the middle-aged group, with a mean age of approximately 46 years. Female participants slightly outnumbered males. The average systolic blood pressure was around 156 mmHg, while the mean diastolic blood pressure was nearly 90 mmHg. The mean serum vitamin D level was found to be in the insufficient range.

References :

1. Cohen JD. Hypertension epidemiology and economic burden: refining risk assessment to lower costs. Manag Care. 2009 Oct;18(10):51-8.
2.  Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc. 2006 Mar;81(3):353-73.
3. Bouillon R, Carmeliet G, Verlinden L, van Etten E, Verstuyf A, Luderer HF, et al. Vitamin D and human health: lessons from vitamin D receptor null mice. Endocr Rev. 2008 Oct;29(6):726-76.
4. Pilz S, März W, Wellnitz B, Seelhorst U, Fahrleitner-Pammer A, Dimai HP, et al. Association of vitamin D deficiency with heart failure and sudden cardiac death in a large cross-sectional study of patients referred for coronary angiography. J Clin Endocrinol Metab. 2008 Oct;93(10):3927-35.
5. Priya S, Singh A, Pradhan A, Himanshu D, Agarwal A, Mehrotra S. Association of Vitamin D and essential hypertension in a North Indian population cohort. Heart India. 2017 Jan 1;5(1):7.
6. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003 May 21;289(19):2560-72.
7. Jeong HY, Park KM, Lee MJ, Yang DH, Kim SH, Lee SY. Vitamin D and Hypertension. Electrolyte Blood Press E BP. 2017 Sep;15(1):1-11.
8. Romano A, Vigna L, Belluigi V, Conti DM, Barberi CE, Tomaino L, et al. Shift work and serum 25-OH vitamin D status among factory workers in Northern Italy: Cross-sectional study. Chronobiol Inter. 2015 Jul 3;32(6):842-7.
9. Mizoue T, Kimura Y, Toyomura K, Nagano J, Kono S, Mibu R, et al. Calcium, dairy foods, vitamin D, and colorectal cancer risk: the Fukuoka Colorectal Cancer Study. Cancer Epidemiol Prevention Biomarkers. 2008 Oct 1;17(10):2800-7.
10. Forman JP, Giovannucci E, Holmes MD, Bischoff-Ferrari HA, Tworoger SS, Willett WC, et al. Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertens Dallas Tex 1979. 2007 May;49(5):1063-9.
11. Griffin FC, Gadegbeku CA, Sowers MR. Vitamin D and subsequent systolic hypertension among women. Am J Hypertens. 2011 Mar;24(3):316-21.
12. Holick MF. Vitamin D deficiency. N Engl J Med 2007;357:266-81.
13. Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin D deficiency among healthy adolescents. Arch Pediatr Adolesc Med 2004;158:531-7.
14. Lips P, Hosking D, Lippuner K, Norquist JM, Wehren L, Maalouf G, et al. The prevalence of vitamin D inadequacy amongst women with osteoporosis: An international epidemiological investigation. J Intern Med 2006;260:245-54.
15. Rostand SG. Ultraviolet light may contribute to geographic and racial blood pressure differences. Hypertension 1997;30:150-6.
16. Melamed ML, Michos ED, Post W, Astor B. 25-hydroxyvitamin D levels and the risk of mortality in the general population. Arch Intern Med 2008;168:1629-37.
17. Autier P, Gandini S. Vitamin D supplementation and total mortality: A metaanalysis of randomized controlled trials. Arch Intern Med 2007;167:17307.
18. Moyad MA. Vitamin D: A rapid review: Side effects and toxicity. Available from: http://www.medscape.com/viewarticle/589256_10. [Last accessed on 2010 Sep 02].
19. Lappe JM, Travers-Gustafson D, Davies KM, Recker RR, Heaney RP. Vitamin D and calcium supplementation reduces cancer risk: Results of a randomized trial. Am J Clin Nutr 2007;85:1586-91.
20. Chlebowski RT, Johnson KC, Kooperberg C, Pettinger M, Wactawski- Wende J, Rohan T, et al. J Natl Cancer Inst 2008;100:1581-91.
21. Stolzenberg-Solomon RZ, Vieth R, Azad A, Pietinen P, Taylor PR, Virtamo J, et al. A prospective nested case-control study of vitamin D status and pancreatic cancer risk in male smokers. Cancer Res 2006;66:10213-9.
22. Stolzenberg-Solomon RZ, Hayes RB, Horst RL, Anderson KE, Hollis BW,  Silverman DT. Serum vitamin D and risk of pancreatic cancer in the Prostate, Lung, Colorectal, and Ovarian Screening Trial. Cancer Res 2009;69:1439-47.
23. Wang TJ, Pencina MJ, Booth SL, Jacques PF, Ingelsson E, Lanier K, et al. Vitamin D deficiency and risk of cardiovascular disease. Circulation 2008;117:503-11.
24. H. F. DeLuca, “Overview of general physiologic features andfunctions of vitamin D,” The American Journal of ClinicalNutrition, vol. 80, no. 6, pp. 1689S–1696S, 2004.
25. M. F. Holick and M. Garabedian, “Vitamin D: photobiology,metabolism((30)), mechanism of action, and clinicalapplications,” in Primer on the Metabolic Bone Diseases andDisorders of Mineral Metabolism, M. J. Favus, Ed., vol. 4, pp. 129–137, American Society for Bone and Mineral Research, Washington, DC, USA, 6^th edition, 2006.
26. M. F. Holick, “Sunlight and vitamin D for bone health andprevention of autoimmune diseases, cancers, and cardiovascular disease,” The American Journal of Clinical Nutrition, vol. 80, no. 6, pp. 1678S–1688S, 2004.
27. M. F. Holick, “Vitamin D: a millenniumperspective,” Journalof Cellular Biochemistry, vol. 88, pp. 296–307, 2003. [10] Y. C. Li, G. Qiao, M. Uskokovic, W. Xiang, W. Zheng, and J.
28. Chen S. Essential hypertension: perspectives and future directions. Journal of hypertension. 2012; 30:42–5.  2
29. Trott DW, Harrison DG. The immune system in hypertension. Advances in physiology education. 2014; 38:20–4. [PubMed: 24585465]
30. Lifton RP, Gharavi AG, Geller DS. Molecular mechanisms of human hypertension. Cell. 2001; 104:545–56. [PubMed: 11239411]
31. Guilluy C, Bregeon J, Toumaniantz G, Rolli-Derkinderen M, Retailleau K, Loufrani L, et al. The Rho exchange factor Arhgef1 mediates the effects of angiotensin II on vascular tone and blood pressure. Nature medicine. 2010; 16:183–90.
32. McGreevy C, Williams D. New insights about vitamin D and cardiovascular disease: a narrative review. Annals of internal medicine. 2011; 155:820–6.
33. Krause R, Buhring M, Hopfenmuller W, Holick MF, Sharma AM. Ultraviolet B and blood pressure. Lancet. 1998; 352:709–10
34. Bhandari SK, Pashayan S, Liu IL, Rasgon SA, Kujubu DA, Tom TY, et al. 25hydroxyvitamin D levels and hypertension rates. Journal of clinical hypertension. 2011; 13:170–7.
35. Dorjgochoo T, Ou Shu X, Xiang YB, Yang G, Cai Q, Li H, et al. Circulating 25hydroxyvitamin D levels in relation to blood pressure parameters and hypertension in the Shanghai Women’s and Men’s Health Studies. The British journal of nutrition. 2012; 108:449–58.
36. Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutrition research. 2011; 31:48–54
37. Hintzpeter B, Mensink GB, Thierfelder W, Muller MJ, Scheidt-Nave C. Vitamin D status and health correlates among German adults. European journal of clinical nutrition. 2008; 62:1079–89.
38. Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, et al. Prevalence of cardiovascular risk factors and the serum levels of 25-hydroxyvitamin D in the United States: data from the Third National Health and Nutrition Examination Survey. Archives of internal medicine. 2007; 167:1159–65.
39. Sabanayagam C, Shankar A, Somasundaram S. Serum vitamin D level and prehypertension among subjects free of hypertension. Kidney & blood pressure research. 2012; 35:106–13.
40. Li YC, Kong J, Wei M et al. 1,25-Dihydroxyvitamin D is a negative endocrine regulator of the renin angisotensin system. J Clin Invest 2002; 100: 229-238.
41. Peupet S, Song Y, Dusek J, Plotnikoff G, Sabatine M, Cheng S, et al. Vitamin D Therapy in Individuals with Pre-Hypertension or Hypertension: The DAYLIGHT Trial. Circulation. 2014
42. Gennari R, Slow S, Stewart AW, Jennings LC, Chambers ST, Priest PC, et al. Long-term high-dose vitamin D3 supplementation and blood pressure in healthy adults: a randomized controlled trial. Hypertension. 2014; 64:725–30
43. BollerslevJ, Zittermann A, Tenderich G, Berthold HK, Stehle P, Koerfer R. Vitamin D supplementation improves cytokine profiles in patients with congestive heart failure: a double-blind, randomized, placebo-controlled trial. The American journal of clinical nutrition. 2006; 83:754–9.
44. Jorde R, Sneve M, Torjesen P, Figenschau Y. No improvement in cardiovascular risk factors in overweight and obese subjects after supplementation with vitamin D3 for 1 year. Journal of internal medicine. 2010; 267:462–72.
45. Scragg R, Slow S, Stewart AW, Jennings LC, Chambers ST, Priest PC, et al. Long-term high-dose vitamin D3 supplementation and blood pressure in healthy adults: a randomized controlled trial. Hypertension. 2014; 64:725–30
46. Pittas AG et al. Vitamin D and calcium intake in relation to to type 2 diabetes in women. Diabetes care 2006; 29(3): 650-656.
47. Kota SK, Kota SK, Jammula S, Meher LK, Panda S. Original Article Renin – angiotensin system activity in vitamin D deficient , obese individuals with hypertension : An urban Indian study. 2011;15.
48. Ullah M, Nadir MA, Struthers AD. Effect of vitamin D on blood pressure: a systematic review and meta-analysis. J Hypertens. 2009;27(10):1948–1954.
49. Kunutsor SK, Apekey TA, Steur M. Vitamin D and risk of future hypertension: meta-analysis of 283,537 participants. Eur J Epidemiol. 2013;28(3):205–221.
50. Witham MD, Adams JS, Bikle DD, et al. The nonskeletal effects of vitamin D: an endocrine society scientific statement. Endocr Rev. 2012;33(3):456–492.
51. Larsen T, Sprague JE, Oh J, et al. Vitamin D deficiency induces high blood pressure and accelerates atherosclerosis in mice. PLoS One. 2013;8(1):e54625.
52. Carrara D, Bernini M, Bacca A, Rugani I, Duranti E, Virdis A. The vitamin D system: a crosstalk between the heart and kidney. Eur J Heart Fail. 2013;12(10): 1031–1041.
53. Vimaleswaran K, Pashayan S, Liu IL, Rasgon SA, Kujubu DA, Tom TY, et al. 25-hydroxyvitamin D levels and hypertension rates. Journal of clinical hypertension. 2011; 13:170–7.
54. Caro D, Burgess S, Munroe PB, Khan H. Vitamin D and high blood pressure: causal association or epiphenomenon? Eur J Epidemiol. 2014;29(1):1–14.
55. Lee D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–269, W64.
56. Kashi MH, Loloei S, Mirjalili MR, Barzegar K. The effect of vitamin D supplementation on blood pressure in patients with elevated blood pressure and vitamin D deficiency: a randomized, double-blind, placebo-controlled trial. Blood pressure monitoring. 2014
57. Sanider JA, Davies JI, Witham MD, Morris AD, Struthers AD. Vitamin D improves endothelial function in patients with Type 2 diabetes mellitus and low vitamin D levels. Diabetic medicine : a journal of the British Diabetic Association. 2008; 25:320–5
58. Burgaz H, Dove FJ, Dryburgh M, Sugden JA, Morris AD, Struthers AD. The effect of different doses of vitamin D(3) on markers of vascular health in patients with type 2 diabetes: a randomised controlled trial. Diabetologia. 2010; 53:2112–9.  59. Wu L, Lithell H, Skarfors E, Wide L, Ljunghall S. Reduction of blood pressure by treatment with alphacalcidol. A double-blind, placebo-controlled study in subjects with impaired glucose tolerance. Acta medica Scandinavica. 1988; 223:211–7.
59. Elamin A, Frand J, Matas Z, Boaz M, Barnea Z, Shargorodsky M. Effect of high doses of vitamin D on arterial properties, adiponectin, leptin and glucose homeostasis in type 2 diabetic patients. Clinical nutrition. 2013; 32:970–5.
60. Jablonski K, E.S. Pole, Nigel Loveridge et al; Reduced Vitamin in Acute Stroke; Journal of the American Heart Association; Stroe. 2006;37:243-245
61. Priya S, Singh A, Pradhan A, Himanshu D,Agarwal A, Mehrotra S. Association of Vitamin D and essential hypertensionin a North Indian population cohort. Heart India 2017;5:7-11.
62. VS Reddy , G Jitinder, Ballala K, Ravi C, Ravi B, Gandhi P, et al. A study on the prevalence of hypertension among young adults in a coastal district of. 2015;(April):32–9.
63. Akbari R, Adelani B, Ghadimi R. Serum vitamin D in hypertensive patients versus healthy controls is there an association? Casp J Intern Med [Internet]. 2016;7(3):168–72.
64. S Faraji. R Zarrin, Zamanian. A The Role of Vitamin D Supplementation in the Treatment of PrimaryHypertension: A Double-Blinded Randomized PlaceboControlledClinical Trial. Iran Red Crescent Med J. 2020; 22(7):e102785.
65. Patil DV, Dutta TK. Correlation between serum vitamin D3 levels and blood pressure in patients with essential hypertension and normotensive individuals. Int J Adv Med 2020;7:971-6.
66. Goel S, Kocharla L, Harris S, Kakarala R. Association of Vitamin D Deficiency with Hypertension in Uninsured Women. J Health Disparities Res Pract. 2012 May 10;3(1).
67. Naghshtabrizi B, Borzouei S, Bigvand P, Seifrabiei MA. Evaluation of the Relationship between Serum 25-Hydroxy Vitamin D and Hypertension in Hamadan, Iran-A Case Control Study. J Clin Diagn Res. 2017 Jul;11(7):LC01LC03
68. Ravinandana Gowda H. V, Mumtaz Ali Khan. ”A Study on Plasma 25-Hydroxy Vitamin D Levels as a Risk Factor in Primary Hypertension”. Journal of Evidence based Medicine and Healthcare; Volume 2, Issue 29, July 20, 2015; Page: 4267-4277, DOI
69. Narayanaswamy M, Iyer V, Khare P,Bodziak ML, Badgett D, Zivadinov R, et al. A study on plasma 25-hydroxy vitamin d levels as a risk factor inPrimary hypertension. PLoS ONE 10(4): e0123771.
70. Mukhtarahmed. Study on Plasma 25-Hydroxy Vitamin D Levelsin Hypertensive Patients.International Journal of Science and Research. 2017;6(10):1197-1201
71. Chan YF, Yiu KH, Siu CW, Kim YH, Li SW, Wong LY, et al. Randomized controlled trial of vitamin D supplement on endothelial function in patients with type 2 diabetes. Atherosclerosis. 2013; 227:140–6.
72. Martins D, Wolf M, Pan D, Zadshir A, Tareen N, Thadhani R, et al. Prevalence of Cardiovascular Risk Factors and the Serum Levels of 25-Hydroxyvitamin D in the United States. Arch Intern Med [Internet]. 2007;167(11):1159.
73. Mateus-Hamdan L, Beauchet O, Bouvard B, Legrand E, Fantino B, Annweiler C. High parathyroid hormone, but not low vitamin D concentrations, expose elderly inpatients to hypertension. Geriatr Gerontol Int. 2013;13(3):783–91.
74. Ke L, Mason RS, Kariuki M, Mpofu E, Brock KE. Vitamin D status and hypertension: A review. Integr Blood Press Control. 2015;8:13–35.
75. Qi D, Nie X, Wu S, Cai J. Vitamin D and hypertension: Prospective study and meta-analysis. PLoS One [Internet]. 2017;12(3):e0174298.
76. O‘Callaghan KM, Kiely M. Systematic review of vitamin D and hypertensive disorders of pregnancy. Nutrients. 2018;10(3):1–18.
77. Duprez D, de Buyzere M, de Backer T, Clement D. Relationship between vitamin D an peripheral circulation in moderate arterial primary hypertension. Blood Press 1994; 3: 389-393.
78. Kristal-Boneh E, Froom P, Harari G,Ribak J. Association of calcitriol and blood pressure in normotensive men. Hypertension 1997; 30: 1289-1294.
79. Pfeifer M, Begerow B, Minne HW et al. Effects of short term vitamin D(3) and calcium supplementation on blood pressure and parathyroid harmone levels in elderly women. J Clin Endocrino Metab 2001; 86: 1633-1637.