Association of 25-hydroxyvitamin D and parathyroid hormone with incident hypertension: MESA (Multi-Ethnic Study of Atherosclerosis).
OBJECTIVE
This study investigated whether lower 25-hydroxyvitamin D and higher parathyroid hormone concentrations are associated with incident hypertension.


BACKGROUND
Disturbances in vitamin D metabolism are plausibly related to hypertension.


METHODS
MESA (Multi-Ethnic Study of Atherosclerosis) is a community-based, prospective cohort with baseline measurements obtained between 2000 and 2002. We studied 3,002 men and women free of prevalent cardiovascular disease and hypertension, age 45 to 84 years at baseline. Serum 25-hydroxyvitamin D and intact parathyroid hormone were measured from previously frozen baseline samples using liquid chromatography-mass spectroscopy and a 2-site immunoassay, respectively. We used a complementary log-log model with interval censoring to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for 25-hydroxyvitamin D and parathyroid hormone concentrations with incident hypertension through 2010.


RESULTS
During a median follow-up of 9.0 years, 41% of the cohort (n = 1,229) developed hypertension. Mean serum 25-hydroxyvitamin D was 26.3 ± 11.2 ng/ml and mean parathyroid hormone was 41.2 ± 17.3 pg/ml. Compared with 25-hydroxyvitamin D ≥30 ng/ml, 25-hydroxyvitamin D <20 ng/ml was associated with a greater hypertension risk (HR: 1.28 [95% CI: 1.09 to 1.50]), although the association was attenuated and not statistically significant after adjusting for potential confounders (HR: 1.13 [95% CI: 0.96 to 1.33]). Compared with parathyroid hormone <33 pg/ml, parathyroid hormone ≥65 pg/ml was associated with a significantly greater risk of hypertension (HR: 1.27 [95% CI: 1.01 to 1.59]) after adjusting for potential confounders.


CONCLUSIONS
Lower 25-hydroxyvitamin D concentrations were not associated with a greater risk of incident hypertension. Higher serum parathyroid hormone concentrations showed a significant, but statistically marginal, relationship to the development of hypertension. These findings will require further confirmation. (Multi-Ethnic Study of Atherosclerosis; NCT00005487).
Department of Health Sciences and the EMGO Institute, VU University Amsterdam, Amsterdam, the Netherlands. Electronic address: hanne.van.ballegooijen@vu.nl.
Adriana J
AJ
van Ballegooijen
Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington.
Bryan
B
Kestenbaum
Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington.
Michael C
MC
Sachs
Kidney Research Institute, Division of Nephrology, University of Washington, Seattle, Washington.
Ian H
IH
de Boer
Departments of Medicine and Epidemiology, Cardiovascular Health Research Unit, University of Washington, Seattle, Washington.
David S
DS
Siscovick
Department of Laboratory Medicine and Medicine, University of Washington, Seattle, Washington.
Andrew N
AN
Hoofnagle
Department of Medicine, University of California San Diego, and the Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, California.
Joachim H
JH
Ix
Department of Health Sciences and the EMGO Institute, VU University Amsterdam, Amsterdam, the Netherlands.
Marjolein
M
Visser
Department of Health Sciences and the EMGO Institute, VU University Amsterdam, Amsterdam, the Netherlands.
Ingeborg A
IA
Brouwer
D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011446:Prospective Studies; D044469:Racial Groups / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D
incident hypertension; parathyroid hormone; prospective study; vitamin D