维生素D缺乏是动脉高血压的危险因素，但随机对照试验显示补充维生素D对血压的影响是多种多样的。因此，多国学者开展了一项单中心、双盲、随机对照试验，旨在评估补充维生素D对24小时动态收缩压监测指标和心血管危险因素的影响。结果表明，予25-羟维生素D水平低的高血压患者补充维生素D并未对其血压和多个心血管危险因素产生显著的影响，但却显著增加患者的甘油三酯水平。相关论文3月23日在线发表于《高血压》(Hypertension)杂志。

        研究者们纳入了200名25-羟维生素D水平低于30 ng/mL的动脉高血压受试者，并将其随机分为为期8周的补充维生素D3滴丸2800 IU/d治疗组或安慰剂组，每组各100名。主要终点指标为24小时动态血压，次要终点指标为24小时收缩压、N端B型钠尿肽前体、QT间期、肾素、醛固酮、24小时尿蛋白排泄、体内稳态模型评估的胰岛素抵抗、甘油三酯、高密度脂蛋白胆固醇水平和脉搏波传导速度。共188名受试者完成了试验，这些受试者的平均年龄为60.1岁，女性47%，25-羟维生素D水平21.2 ng/mL。

        结果显示，受试者24小时收缩压平均降低0.4 mm Hg (P=0.712)。甘油三酯水平显著增加(平均增加17 mg/dL，P=0.013)。未观察到次要终点指标进一步显著的影响。

        参考文献：Stefan Pilz, et al.Hypertension 2015; first published on March 23 2015 asdoi:10.1161/HYPERTENSIONAHA.115.05319

Effects of Vitamin D on Blood Pressure and Cardiovascular Risk Factors
A Randomized Controlled Trial

Abstract
Vitamin D deficiency is a risk factor for arterial hypertension, but randomized controlled trials showed mixed effects of vitamin D supplementation on blood pressure (BP). We aimed to evaluate whether vitamin D supplementation affects 24-hour systolic ambulatory BP monitoring values and cardiovascular risk factors. The Styrian Vitamin D Hypertension Trial is a single-center, double-blind, placebo-controlled study conducted from June 2011 to August 2014 at the endocrine outpatient clinic of the Medical University of Graz, Austria. We enrolled 200 study participants with arterial hypertension and 25-hydroxyvitamin D levels below 30 ng/mL. Study participants were randomized to receive either 2800 IU of vitamin D3 per day as oily drops (n=100) or placebo (n=100) for 8 weeks. Primary outcome measure was 24-hour systolic BP. Secondary outcome measures were 24-hour diastolic BP, N-terminal-pro-B-type natriuretic peptide, QTc interval, renin, aldosterone, 24-hour urinary albumin excretion, homeostasis model assessment-insulin resistance, triglycerides, high-density lipoprotein cholesterol, and pulse wave velocity. A total of 188 participants (mean [SD] age, 60.1 [11.3] years; 47% women; 25-hydroxyvitamin D, 21.2 [5.6] ng/mL) completed the trial.
The mean treatment effect (95% confidence interval) for 24-hour systolic BP was −0.4 (−2.8 to 1.9) mm Hg (P=0.712). Triglycerides increased significantly (mean change [95% confidence interval], 17 [1–33] mg/dL;P=0.013), but no further significant effects were observed for secondary outcomes.
Vitamin D supplementation in hypertensive patients with low 25-hydroxyvitamin D has no significant effect on BP and several cardiovascular risk factors, but it was associated with a significant increase in triglycerides.