PT  - JOURNAL ARTICLE
AU  - Artaza Gilani
AU  - Sheena Ramsay
AU  - Paul Welsh
AU  - Olia Papacosta
AU  - Lucy Lennon
AU  - Peter Whincup
AU  - S Goya Wannamethee
TI  - Vitamin D deficiency is associated with increased risk of postural hypotension in older men: a cross-sectional analysis from The British Regional Heart Study
AID  - 10.3399/bjgp20X711209
DP  - 2020 Jun 01
TA  - British Journal of General Practice
PG  - bjgp20X711209
VI  - 70
IP  - suppl 1
4099  - http://bjgp.org/content/70/suppl_1/bjgp20X711209.short
4100  - http://bjgp.org/content/70/suppl_1/bjgp20X711209.full
SO  - Br J Gen Pract2020 Jun 01; 70
AB  - Background There is growing interest in the role of vitamin D in extra-skeletal health, including postural hypotension. Postural hypotension is found in 1 in 5 community-dwelling adults aged 60 years and above. It increases risk of falls, fractures, cardiovascular disease and all-cause mortality. Better understanding of the aetiology of postural hypotension may help yield more effective treatment options than those that are currently available.Aim The aim of this study was to investigate the association between circulating vitamin D, parathyroid hormone and postural hypotension.Method This was a cross-sectional analysis of 3620 community-dwelling men living in the UK (mean age 68.6 years; standard deviation 5.5 years). Vitamin D status (nmol/L) was categorised as sufficient (≥50), insufficient (≥25 – <50), or deficient (<25). Parathyroid hormone levels were categorised by quintiles. Postural hypotension was defined by consensus criteria as a decrease in systolic blood pressure ≥20 mmHg and/or diastolic blood pressure ≥10 mmHg that occurred within three minutes of standing.Results Compared to sufficient levels of vitamin D, vitamin D deficiency increased risk of postural hypotension that specifically occurred within one minute of standing (OR 1.51, 95% CI = 1.06 to 2.15) in multinomial, multiple logistic regression. Neither vitamin D insufficiency, nor elevated parathyroid hormone, were associated with postural hypotension.Conclusion In this study, vitamin D deficiency was associated with increased risk of postural hypotension. Further research may help clarify whether treating vitamin D deficiency can reduce the degree of postural hypotension, or if preventing the progression to vitamin D deficiency can reduce the incidence of postural hypotension.