title: Joint Association of Low Vitamin D and Vitamin K Status With Blood Pressure and Hypertension.
abstract: Low vitamin D and K status are both associated with an increased cardiovascular risk. New evidence from experimental studies on bone health suggest an interaction between vitamin D and K; however, a joint association with vascular health outcomes is largely unknown. To prospectively investigate whether the combination of low vitamin D and K status is associated with higher systolic and diastolic blood pressure in 402 participants and with incident hypertension in 231 participants free of hypertension at baseline. We used data from a subsample of the Longitudinal Aging Study Amsterdam, a population-based cohort of Dutch participants aged 55 to 65 years. Vitamin D and K status were assessed by 25-hydroxyvitamin D and dp-ucMGP (dephosphorylated uncarboxylated matrix gla protein) concentrations (high dp-ucMGP is indicative for low vitamin K status) in stored samples from 2002 to 2003. Vitamin D and K status were categorized into 25-hydroxyvitamin D <50/≥50 mmol/L and median dp-ucMGP <323/≥323 pmol/L. During a median follow-up of 6.4 years, 62% of the participants (n=143) developed hypertension. The combination of low vitamin D and K status was associated with increased systolic 4.8 mm Hg (95% confidence interval, 0.1-9.5) and diastolic 3.1 mm Hg (95% confidence interval, 0.5-5.7) blood pressure compared with high vitamin D and K status (Pfor interaction =0.013 for systolic blood pressure and 0.068 for diastolic blood pressure). A similar trend was seen for incident hypertension: hazard ratio=1.62 (95% confidence interval, 0.96-2.73) for the low vitamin D and K group. The combination of low vitamin D and K status was associated with increased blood pressure and a trend for greater hypertension risk.
authors.affiliation: From the Department of Health Sciences, and the EMGO Institute for Health and Care Research (A.J.v.B., A.C., M.V., I.A.B.), Department of Internal Medicine, Section of Nutrition and Dietetics (M.V.), and Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research (N.M.v.S., J.W.B.), VU University Medical Center, Amsterdam; and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (J.W.B.). hanne.van.ballegooijen@vu.nl.
authors.forename: Adriana J
authors.initials: AJ
authors.lastname: van Ballegooijen
authors.affiliation: From the Department of Health Sciences, and the EMGO Institute for Health and Care Research (A.J.v.B., A.C., M.V., I.A.B.), Department of Internal Medicine, Section of Nutrition and Dietetics (M.V.), and Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research (N.M.v.S., J.W.B.), VU University Medical Center, Amsterdam; and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (J.W.B.).
authors.forename: Aivaras
authors.initials: A
authors.lastname: Cepelis
authors.affiliation: From the Department of Health Sciences, and the EMGO Institute for Health and Care Research (A.J.v.B., A.C., M.V., I.A.B.), Department of Internal Medicine, Section of Nutrition and Dietetics (M.V.), and Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research (N.M.v.S., J.W.B.), VU University Medical Center, Amsterdam; and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (J.W.B.).
authors.forename: Marjolein
authors.initials: M
authors.lastname: Visser
authors.affiliation: From the Department of Health Sciences, and the EMGO Institute for Health and Care Research (A.J.v.B., A.C., M.V., I.A.B.), Department of Internal Medicine, Section of Nutrition and Dietetics (M.V.), and Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research (N.M.v.S., J.W.B.), VU University Medical Center, Amsterdam; and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (J.W.B.).
authors.forename: Ingeborg A
authors.initials: IA
authors.lastname: Brouwer
authors.affiliation: From the Department of Health Sciences, and the EMGO Institute for Health and Care Research (A.J.v.B., A.C., M.V., I.A.B.), Department of Internal Medicine, Section of Nutrition and Dietetics (M.V.), and Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research (N.M.v.S., J.W.B.), VU University Medical Center, Amsterdam; and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (J.W.B.).
authors.forename: Natasja M
authors.initials: NM
authors.lastname: van Schoor
authors.affiliation: From the Department of Health Sciences, and the EMGO Institute for Health and Care Research (A.J.v.B., A.C., M.V., I.A.B.), Department of Internal Medicine, Section of Nutrition and Dietetics (M.V.), and Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research (N.M.v.S., J.W.B.), VU University Medical Center, Amsterdam; and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht (J.W.B.).
authors.forename: Joline W
authors.initials: JW
authors.lastname: Beulens
mesh_terms: D000375:Aging / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015331:Cohort Studies; D016001:Confidence Intervals; D018450:Disease Progression; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*; D014813:Vitamin K Deficiency / Q000097:blood / Q000150:complications*
keywords: 25-hydroxyvitamin D; blood pressure; epidemiology; incident hypertension; vitamin K status