Correction of vitamin D deficiency/insufficiency and assessment of 24-hour blood pressure parameters in perimenopausal women with arterial hypertension

Department of Outpatient Therapy, Grodno State Medical University, Grodno, Belarus. Head of Department: Cand. Sc. (Med.), Associate Professor Liudmila Valeryevna Yankouskaya
Correspondence: Department of Outpatient Therapy, Grodno State Medical University, 80 Gorky Street, 230009 Grodno, Belarus, e-mail: yankovliuda@yandex.ru

Pediatr Med Rodz Vol 10 Numer 3, p. 278–290
DOI: 10.15557/PiMR.2014.0031
ABSTRACT

Both arterial hypertension and vitamin D deficiency are highly prevalent in the general population. Aim of the study was to assess blood pressure and its dynamics in 24-hour ambulatory blood pressure monitoring (ABPM) while correcting the vitamin D deficiency/insufficiency in perimenopausal women, who have grade 2 arterial hypertension. Material and methods: The study group consisted of 50 premenopausal women [48 (45–50) years] and 52 women in early (up to 5 years) postmenopausal period [52 (50–54) years]. Total 25-(OH)D blood plasma levels were assessed by immunoenzyme assay using DRG kit (Marburg, Germany). The total 25-(OH)D blood plasma levels below 20 ng/ml were considered as vitamin D insufficiency, the concentration of 20–30 ng/ml – as deficiency, and the levels 30–60 ng/ml were considered normal. In the group of women with 25-(OH)D deficiency/insufficiency two subgroups were isolated: IB subgroup (n = 25) and IIB (n = 21), which were introduced with treatment algorithm, including cholecalciferol administration at a daily dose of 2000 IU for 3 months. Results: Cholecalciferol therapy at a dose of 2000 IU per day for a period of 3 months has allowed reaching the optimum concentration of vitamin D in 80% of premenopausal hypertensive women, and in 76.2% of women in the early postmenopausal period. Correction of plasma vitamin D deficiency achieved by taking cholecalciferol, while using combined antihypertensive therapy (ramipril + indapamide) allows to improve the following parameters assessed in ambulatory blood pressure monitoring in premenopausal women: the mean daytime and nighttime systolic blood pressure, time index of 24-hour and daytime systolic blood pressure, nighttime blood pressure variability, systolic and diastolic blood pressure morning surge, and normalization of nighttime:daytime blood pressure ratio; in postmenopausal women the treatment allowed: the reduction of morning surge of diastolic blood pressure, normalization of daytime systolic blood pressure variability, and nighttime diastolic blood pressure time index.

Keywords: arterial hypertension, vitamin D, menopause