Associations of 25-Hydroxyvitamin D With the Blood Pressure Response to Maximal Exercise Among Healthy Adults

in International Journal of Sport Nutrition and Exercise Metabolism

Click name to view affiliation

Amanda ZaleskiUniversity of Connecticut
Hartford Hospital

Search for other papers by Amanda Zaleski in
Current site
Google Scholar
PubMed
Close
*
,
Beth TaylorUniversity of Connecticut
Hartford Hospital

Search for other papers by Beth Taylor in
Current site
Google Scholar
PubMed
Close
*
,
Braden ArmstrongUniversity of Connecticut

Search for other papers by Braden Armstrong in
Current site
Google Scholar
PubMed
Close
*
,
Michael PuglisiUniversity of Connecticut

Search for other papers by Michael Puglisi in
Current site
Google Scholar
PubMed
Close
*
,
Priscilla ClarksonUniversity of Massachusetts

Search for other papers by Priscilla Clarkson in
Current site
Google Scholar
PubMed
Close
*
,
Stuart ChipkinUniversity of Massachusetts

Search for other papers by Stuart Chipkin in
Current site
Google Scholar
PubMed
Close
*
,
Charles Michael WhiteUniversity of Connecticut
Hartford Hospital

Search for other papers by Charles Michael White in
Current site
Google Scholar
PubMed
Close
*
,
Paul D. ThompsonHartford Hospital

Search for other papers by Paul D. Thompson in
Current site
Google Scholar
PubMed
Close
*
, and
Linda S. PescatelloUniversity of Connecticut

Search for other papers by Linda S. Pescatello in
Current site
Google Scholar
PubMed
Close
*
Restricted access

Insufficient 25-hydroxyvitamin D [25(OH)D] levels are associated with high resting blood pressure (BP). However, the relationship between 25(OH)D and the peak systolic BP (SBP) response to exercise, a predictor of future hypertension, has yet to be investigated. We sought to examine the relationship among serum 25(OH)D and the peak SBP response to a graded exercise stress test (GEST) among a large sample (n = 417) of healthy men (49%) and women (51%) over a broad age range (20–76 years; mean age: 44.1 ± 0.8 years). We hypothesized that individuals with clinically insufficient 25(OH)D would have a greater peak SBP response to a GEST compared to individuals with sufficient 25(OH)D levels. Fasting serum 25(OH)D, anthropometrics, resting BP, and peak exercise SBP were obtained at the baseline visit of a larger clinical trial (STOMP; NCT01140308). Mean 25(OH)D levels were 36.1 ± 0.7 ng/ml, with ∼35% of individuals classified as insufficient (<30 ng/ml). Average resting BP was 119 ± 13 mmHg/75 ± 10 mmHg, with 52.3% considered to have normal BP, while 25.2% had elevated BP and 22.5% had established hypertension. The peak SBP response to a GEST was similar between individuals with sufficient (48 ± 19 mmHg) versus insufficient (48 ± 18 mmHg) 25(OH)D (p = 1.000). One unexpected finding emerged such that individuals with sufficient 25(OH)D had higher resting SBP (120 ± 14 mmHg vs. 117 ± 13 mmHg; p = .020) than individuals with insufficient 25(OH)D. In contrast to our hypothesis, 25(OH)D levels were not associated with the peak SBP response to a GEST. Baseline 25(OH)D levels were positively correlated with resting SBP; however, the magnitude of this effect is likely not clinically meaningful.

Zaleski is with the Dept. of Kinesiology, University of Connecticut, Storrs, CT. Taylor, Armstrong, Puglisi, White, and Pescatello are with the University of Connecticut, Storrs, CT. Zaleski, Taylor, White, and Thompson are with Hartford Hospital, Hartford, CT. Clarkson and Chipkin are with the University of Massachusetts, Amherst, MA. P. Clarkson is now deceased.

Address author correspondence to Amanda Zaleski at amanda.zaleski@uconn.edu.
  • Collapse
  • Expand
  • Al Mheid, I., Patel, R., Murrow, J., Morris, A., Rahman, A., Fike, L., . . . Quyyumi, A.A. (2011). Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans. Journal of the American College of Cardiology, 58(2), 186192. PubMed ID: 21718915 doi:10.1016/j.jacc.2011.02.051

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Al Mheid, I., & Quyyumi, A.A. (2017). Vitamin D and cardiovascular disease: Controversy unresolved. Journal of the American College of Cardiology, 70(1), 89100. PubMed ID: 28662812 doi:10.1016/j.jacc.2017.05.031

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Babur Guler, G., Guler, E., Hatipoglu, S., Gunes, H.M., Gecmen, C., Demir, G.G., & Barutcu, I. (2016). Assessment of 25-OH vitamin D levels and abnormal blood pressure response in female patients with cardiac syndrome X. Anatolian Journal of Cardiology, 16(12), 961966. PubMed ID: 27271477 doi:10.14744/AnatolJCardiol.2016.6862

    • Search Google Scholar
    • Export Citation
  • Benbassat, J., & Froom, P. (1986). Blood pressure response to exercise as a predictor of hypertension. Archives of Internal Medicine, 146(10), 20532055.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Burgaz, A., Orsini, N., Larsson, S.C., & Wolk, A. (2011). Blood 25-hydroxyvitamin D concentration and hypertension: A meta-analysis. Journal of Hypertension, 29(4), 636645. PubMed ID: 21191311 doi:10.1097/HJH.0b013e32834320f9

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Chen, C., Wei, J., AlBadri, A., Zarrini, P., & Bairey Merz, C.N. (2016). Coronary microvascular dysfunction—Epidemiology, pathogenesis, prognosis, diagnosis, risk factors and therapy. Circulation Journal, 81(1), 311. doi:10.1253/circj.CJ-16-1002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dawson-Hughes, B., Heaney, R.P., Holick, M.F., Lips, P., Meunier, P.J., & Vieth, R. (2005). Estimates of optimal vitamin D status. Osteoporosis International, 16(7), 713716. doi:10.1007/s00198-005-1867-7

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Dawson-Hughes, B., Mithal, A., Bonjour, J.P., Boonen, S., Burckhardt, P., Fuleihan, G.E., . . . Yoshimura, N. (2010). IOF position statement: Vitamin D recommendations for older adults. Osteoporosis International, 21(7), 11511154. doi:10.1007/s00198-010-1285-3

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Forman, J.P., Giovannucci, E., Holmes, M.D., Bischoff-Ferrari, H.A., Tworoger, S.S., Willett, W.C., & Curhan, G.C. (2007). Plasma 25-hydroxyvitamin D levels and risk of incident hypertension. Hypertension, 49(5), 10631069. doi:10.1161/HYPERTENSIONAHA.107.087288.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Forrest, K.Y., & Stuhldreher, W.L. (2011). Prevalence and correlates of vitamin D deficiency in US adults. Nutrition Research, 31(1), 4854. doi:10.1016/j.nutres.2010.12.001

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Holick, M.F. (2007). Vitamin D deficiency. The New England Journal of Medicine, 357(3), 266281. PubMed ID: 17634462 doi:10.1056/NEJMra070553

  • Howley, E.T., Bassett, D.R., Jr., & Welch, H.G. (1995). Criteria for maximal oxygen uptake: Review and commentary. Medicine & Science in Sports & Exercise, 27(9), 12921301. PubMed ID: 8531628 doi:10.1249/00005768-199509000-00009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Institute of Medicine (US) Committee to Review Dietary Reference Intakes for Vitamin D and Calcium. (2011). Dietary reference intakes for calcium and vitamin D. (Accession No.NBK56070)

    • Search Google Scholar
    • Export Citation
  • Kim, D., & Ha, J.W. (2016). Hypertensive response to exercise: Mechanisms and clinical implication. Clinical Hypertension, 22, 17. PubMed ID: 27468357 doi:10.1186/s40885-016-0052-y

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Kramer, H., Berns, J.S., Choi, M.J., Martin, K., & Rocco, M.V. (2014). 25-Hydroxyvitamin D testing and supplementation in CKD: An NKF-KDOQI controversies report. American Journal of Kidney Diseases, 64(4), 499509. doi:10.1053/j.ajkd.2014.05.018

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Lewis, G.D., Gona, P., Larson, M.G., Plehn, J.F., Benjamin, E.J., O’Donnell, C.J., . . . Wang, T.J. (2008). Exercise blood pressure and the risk of incident cardiovascular disease (from the Framingham Heart Study). The American Journal of Cardiology, 101(11), 16141620. PubMed ID: 18489939 doi:10.1016/j.amjcard.2008.01.046

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Martins, D., Wolf, M., Pan, D., Zadshir, A., Tareen, N., Thadhani, R., . . . Norris, K. (2007). 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, 167(11), 11591165. PubMed ID: 17563024 doi:10.1001/archinte.167.11.1159

    • Crossref
    • Search Google Scholar
    • Export Citation
  • McGreevy, C., Barry, M., Davenport, C., Byrne, B., Donaghy, C., Collier, G., . . . Williams, D. (2015). The effect of vitamin D supplementation on arterial stiffness in an elderly community-based population. Journal of the American Society of Hypertension, 9(3), 176183. PubMed ID: 25681237 doi:10.1016/j.jash.2014.12.019

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Muntner, P., Carey, R.M., Gidding, S., Jones, D.W., Taler, S.J., Wright, J.T., Jr., & Whelton, P.K. (2018). Potential U.S. population impact of the 2017 ACC/AHA high blood pressure guideline. Circulation, 137(2), 109118. doi:10.1161/CIRCULATIONAHA.117032582

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Muscogiuri, G., Annweiler, C., Duval, G., Karras, S., Tirabassi, G., Salvio, G., . . . Colao, A. (2017). Vitamin D and cardiovascular disease: From atherosclerosis to myocardial infarction and stroke. International Journal of Cardiology, 230, 577584. PubMed ID: 28043680 doi:10.1016/j.ijcard.2016.12.053

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Ni, W., Watts, S.W., Ng, M., Chen, S., Glenn, D.J., & Gardner, D.G. (2014). Elimination of vitamin D receptor in vascular endothelial cells alters vascular function. Hypertension, 64(6), 12901298. PubMed ID: 25201890 doi:10.1161/HYPERTENSIONAHA.114.03971

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Parker, B.A., Capizzi, J.A., Grimaldi, A.S., Clarkson, P.M., Cole, S.M., Keadle, J., . . . Thompson, P.D. (2013). Effect of statins on skeletal muscle function. Circulation, 127(1), 96103. PubMed ID: 23183941 doi:10.1161/CIRCULATIONAHA.112.136101

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Pescatello, L., Arena, R., Riebe, D., & Thompson, P. (2013). ACSM’s guidelines for exercise testing and prescription (9th ed.). Baltimore, ML: Lippincott Williams & Wilkins.

    • Search Google Scholar
    • Export Citation
  • Pickering, T.G., Hall, J.E., Appel, L.J., Falkner, B.E., Graves, J.W., Hill, M.N., . . . Council on High Blood Pressure Research Professional and Public Education Subcommittee, American Heart Association. (2005). Recommendations for blood pressure measurement in humans: An AHA scientific statement from the council on high blood pressure research professional and public education subcommittee. The Journal of Clinical Hypertension, 7(2), 102109. doi:10.1111/j.1524-6175.2005.04377.x.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Razzaque, M.S. (2011). The dualistic role of vitamin D in vascular calcifications. Kidney International, 79(7), 708714. PubMed ID: 20962746 doi:10.1038/ki.2010.432

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Riebe, D., Ehrman, J., Liguori, G., & Magel, M. (2017). ACSM’s guidelines for exercise testing and prescription (10th ed.). Philadelphia, PA: Wolters Kluwer.

    • Search Google Scholar
    • Export Citation
  • Schulz, E., Steven, S., & Munzel, T. (2014). Is at least one vitamin helping our vasculature? Evidence for an important role of the endothelial vitamin D receptor in regulating endothelial function and blood pressure. Hypertension, 64(6), 11871188. PubMed ID: 25201891 doi:10.1161/HYPERTENSIONAHA.114.04118

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Syme, A.N., Blanchard, B.E., Guidry, M.A., Taylor, A.W., Vanheest, J.L., Hasson, S., . . . Pescatello, L.S. (2006). Peak systolic blood pressure on a graded maximal exercise test and the blood pressure response to an acute bout of submaximal exercise. The American Journal of Cardiology, 98(7), 938943. PubMed ID: 16996879 doi:10.1016/j.amjcard.2006.05.012

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Thompson, P.D., Parker, B.A., Clarkson, P.M., Pescatello, L.S., White, C.M., Grimaldi, A.S., . . . Hoffman, E.P. (2010). A randomized clinical trial to assess the effect of statins on skeletal muscle function and performance: Rationale and study design. Preventive Cardiology, 13(3), 104111. PubMed ID: 20626664 doi:10.1111/j.1751-7141.2009.00063.x

    • Search Google Scholar
    • Export Citation
  • Vieth, R. (2011). Why the minimum desirable serum 25-hydroxyvitamin D level should be 75 nmol/L (30 ng/ml). Best Practice & Research. Clinical Endocrinology & Metabolism, 25(4), 681691. PubMed ID: 21872808 doi:10.1016/j.beem.2011.06.009

    • Crossref
    • Search Google Scholar
    • Export Citation
  • Whelton, P.K., Carey, R.M., Aronow, W.S., Casey, D.E., Jr., Collins, K.J., Dennison Himmelfarb, C., . . . Wright, J.T., Jr. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task force on clinical practice guidelines. Hypertension, 71(6), 13115. doi:10.1161/HYP0000000000000065

    • Search Google Scholar
    • Export Citation
  • Zaleski, A., Panza, G., Swales, H., Arora, P., Newton-Cheh, C., Wang, T., . . . Taylor, B. (2015). High-dose versus low-dose vitamin D supplementation and arterial stiffness among individuals with prehypertension and vitamin D deficiency. Disease Markers, 2015, 918968. PubMed ID: 26451070 doi:10.1155/2015/918968

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 1725 688 40
Full Text Views 39 6 0
PDF Downloads 37 8 1