title: Racial disparity in blood pressure: is vitamin D a factor?
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.
  
  
  METHODS
  Cross-sectional analysis.
  
  
  METHODS
  Adult non-Hispanic Black and White participants from the National Health and Nutrition Examination Survey 2001-2006.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Family Medicine, University of Rochester School of Medicine, Rochester, NY 14620, USA. Kevin_Fiscella@URMC.rochester.edu
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Paul
authors.initials: P
authors.lastname: Winters
authors.forename: Dan
authors.initials: D
authors.lastname: Tancredi
authors.forename: Peter
authors.initials: P
authors.lastname: Franks
mesh_terms: D000328:Adult; D044383:Black People / Q000235:genetics; D001794:Blood Pressure / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000208:ethnology / Q000235:genetics; D014807:Vitamin D / Q000097:blood / Q000502:physiology*; D014808:Vitamin D Deficiency / Q000097:blood / Q000208:ethnology*; D044465:White People / Q000235:genetics; D001741:Black or African American
chemical_list: D014807:Vitamin D