Low Vitamin D Status Is Associated with Vascular Changes in the Carotid Artery

by | Mar 3, 2025 | 2024, Blood Pressure, Cardiovascular Health, Recent Articles, Vitamin D - Recommended Levels

Written by Chrystal Moulton, Science Writer. Sub-optimal vitamin D status is associated with increased glucose (P=.037), insulin (P=0.044), HOMA index (P=0.044), and parathyroid hormone levels (P<0.001).

stethoscopeSubclinical cardiac and vascular changes generally occurs in individuals with hypertension1. Such changes can be observed using ultrasound technology to measure the intima-media thickness (IMT) of the carotid artery, an important biomarker of cardiovascular risk2,3. Also, the relationship between vitamin D and cardiovascular plainly establishes the importance of vitamin D status in management and maintenance of cardiovascular health4,5. Studies specifically in patients with hypertension has shown that vitamin D deficiency is associated with stiffening of the carotid artery and changes in the artery wall6,7. Aging, as well, is significantly associated with changes in the arterial walls1. Thus, in the current trial, researchers investigated the association between vascular changes in the carotid artery and vitamin D status in middle-aged adults diagnosed with hypertension without history of diabetes, renal dysfunction, or major cardiovascular disease1.

This study as designed as a cross-sectional trial. Two-hundred twenty-three patients between 18-70 years old with hypertension were included in the study. Hypertension was based on blood pressure measurements taken over 3 separate visits. Outdoor activity was evaluated through interviews. Blood samples were collected from each participant to measure HOMA index, parathyroid hormone levels, and vitamin D status [25(OH)D]. Ultrasound was done on the right and left carotid arteries to measure IMT and pulse pressure was calculated as an average of 3 measures. Carotid stiffness was reported in 3 indices: beta-stiffness, coefficient of distensibility, and Young’s elastic modulus. Participants were categorized into 3 groups based on serum vitamin D status: deficient (<21ng/mL 25 (OH)D), insufficient (21-29ng/mL 25(OH)D, and normal (>30ng/mL 25(OH)D). Logistical regression analysis was, then, applied to determine any association between vitamin D status and vascular changes in the carotid artery.

Of 223 patients in this study, 94 never received treatment for hypertension. The average age of participants was 50 ±13years old. Vitamin D deficiency was observed in 36% of participants [n=80] followed by insufficiency at 23% [n=51]. Ninety-two patients had normal vitamin D status. Based on initial characteristics, sub-optimal vitamin D status is associated with increased glucose (P=.037), insulin (P=0.044), HOMA index (P=0.044), and parathyroid hormone levels (P<0.001). Researchers also observed a significant decrease in the active form of vitamin D (P<0.001) and a decline in vitamin status in spring and winter compared to summer and fall (P<0.001). No significant differences were observed between subjects treated for hypertension versus those who were not receiving treatment. When stratified by age, researchers observed an increase in stiffness and carotid thickness (IMT) as well as a decrease in vitamin D status with age. Stratified by sex, no significant differences were observed between male and female participants. Furthermore, researchers observed a significantly higher incidence of carotid artery thickness (P<0.001) and plaques (P=0.026) with decreasing vitamin D status. Logistical regression models showed that age, glucose level, HOMA index, parathyroid hormone level, carotid IMT, and measures of arterial stiffness (Young’s and Beta-stiffness) were both negatively and significantly associated with log 25(OH)D (P<0.05). Coefficient of distensibility was positively associated with log 25(OH)D (P<0.001). Duration of hypertension was also negatively associated with log 25(OH)D (P=0.006). Multivariate regression analysis showed that carotid IMT was independently associated with age (P<0.001), systolic BP (P=0.006), log25(OH)D (P=0.004), and Log parathyroid hormone (P=0.04). Distensibility, however, was independently correlated with BMI (P=0.015), age (P=0.002), log25(OH)D (P=0.002), and systolic BP (P=0.045).

Overall, results from this evaluation showed that suboptimal vitamin D status was associated with higher carotid intima-media thickness, an increase in carotid plaques, and stiffening of the artery. The analysis also demonstrated that vitamin D status is negatively associated with carotid intima-media thickness and positively associated with distensibility. Further analysis will be need to verify these findings.

Source: Bulfone, Luca, Antonio Vacca, Gabriele Brosolo, Andrea Da Porto, Nicole Bertin, Cinzia Vivarelli, Cristiana Catena, and Leonardo A. Sechi. “Subclinical Carotid Disease Is Associated with Low Serum Vitamin D in Nondiabetic Middle-Aged Hypertensive Patients.” Nutrients 17, no. 3 (2025): 480.

© 2025 by the author. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/license
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Posted March 3, 2025.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

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