The Role of Vitamin D Supplementation in the Treatment of Primary Hypertension: A Double-Blinded Randomized Placebo-Controlled Clinical Trial


Vitamin D Deficiency
Ambulatory Blood Pressure Monitoring
Vitamin D

How to Cite

Faraji, S. ., Zarrin, R., Zamanian , A. ., Hajizadeh, R. ., Ayremlou , P. ., & Rahimi, B. (2020). The Role of Vitamin D Supplementation in the Treatment of Primary Hypertension: A Double-Blinded Randomized Placebo-Controlled Clinical Trial. Iranian Red Crescent Medical Journal, 22(7). Retrieved from



Background: Hypertension is one of the most serious global concerns since it has affected over 1.2 billion people.

Objectives: The present study aimed to determine the effect of vitamin D supplementation on blood pressure, fasting blood sugar, and lipid profile in hypertensive patients with vitamin D deficiency.

Methods: In this double-blinded randomized placebo-controlled clinical trial study, 116 hypertensive patients (intervention and placebo groups, 58 each) with vitamin D deficiency (< 30 ng/mL with ECL) for 14 weeks, started from the beginning of autumn 2019 in Seyed-al-Shohada Educational Hospital in Urmia City. Fifty-five patients (49%) were male with the mean vitamin D 15.89 ± 5.09 ng/mL and 57 females with 17.29 ± 6.31 ng/mL. In a stratified blocked randomization scheme, the patients were randomly allocated into similar sized intervention and control groups based on body mass index (BMI), then the randomization with four block size was performed in each of strata by random allocation software. The intervention group received six doses of 50,000 IU vitamin D supplements for 6 weeks, then two supplements for two following months (one capsule per month). Blood pressure (24/h blood pressure measured by an ambulatory blood pressure monitoring device), vitamin D, FBS, and lipid profile (HDL, LDL, CL, and TG) were all measured at baseline and end of the study. Physical activity (measured by short IPAQ questionnaire), sun exposure using a questionnaire, dietary intake of vitamin D using three 24-hour recalls during the intervention, and anthropometric indices were measured at baseline, middle, and end of the study. Fifty-six patients in each group completed the study. The study was approved by the Ethics Committee of the Urmia University of Medical Sciences (ethics code: IR.UMSU.REC.1398.192).

Results: The office blood pressure, 24-h systolic blood pressure (SBP) and diastolic blood pressure (DBP), nighttime SBP and DBP were significantly reduced in the intervention group compared to the control group, whereas the reduction of daytime SBP and DBP was not statistically significant. Vitamin D supplementation significantly decreased serum triglyceride, cholesterol, and LDL levels.

Conclusions: Vitamin D supplementation had positive effects on blood pressure, triglyceride, cholesterol, and LDL levels in patients with low serum vitamin D.




  1. Oparil S, Acelajado MC, Bakris GL, Berlowitz DR, Cifkova R, Dominiczak AF, et al. Hypertension. Nat Rev Dis Primers. 2018;4:18014. doi: 10.1038/nrdp.2018.14. [PubMed: 29565029]. [PubMed Central: PMCPmc6477925].
  2. Mirzaei M, Moayedallaie S, Jabbari L, Mohammadi M. Prevalence of Hypertension in Iran 1980-2012: A Systematic Review. J Tehran Heart Cent. 2016;11(4):159-67. [PubMed: 28496506]. [PubMed Central: PMCPmc5424849].
  3. Legarth C, Grimm D, Wehland M, Bauer J, Kruger M. The Impact of Vitamin D in the Treatment of Essential Hypertension. Int J Mol Sci. 2018;19(2). doi: 10.3390/ijms19020455. [PubMed: 29401665]. [PubMed Central: PMC5855677].
  4. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JJ, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. Jama. 2003;289(19):2560-72. doi: 10.1001/jama.289.19.2560. [PubMed: 12748199].
  5. Rossier BC, Bochud M, Devuyst O. The Hypertension Pandemic: An Evolutionary Perspective. Physiology (Bethesda). 2017;32(2):112-25. doi: 10.1152/physiol.00026.2016. [PubMed: 28202622].
  6. Messerli FH, Williams B, Ritz E. Essential hypertension. Lancet. 2007;370(9587):591-603. doi: 10.1016/s0140-6736(07)61299-9. [PubMed: 17707755].
  7. Chen S, Sun Y, Agrawal DK. Vitamin D deficiency and essential hypertension. J Am Soc Hypertens. 2015;9(11):885-901. doi: 10.1016/j.jash.2015.08.009. [PubMed: 26419755]. [PubMed Central: PMCPmc4641765].
  8. Onusko E. Diagnosing secondary hypertension. Am Fam Physician. 2003;67(1):67-74. [PubMed: 12537168].
  9. Sukor N. Secondary hypertension: a condition not to be missed. Postgrad Med J. 2011;87(1032):706-13. doi: 10.1136/pgmj.2011.118661. [PubMed: 21746730].
  10. de la Sierra A. [Ambulatory blood pressure monitoring is a useful tool for all patients]. Hipertens Riesgo Vasc. 2017;34(1):45-9. Spanish. doi: 10.1016/j.hipert.2016.06.004. [PubMed: 27474527].
  11. Vasan RS. High Blood Pressure in Young Adulthood and Risk of Premature Cardiovascular Disease: Calibrating Treatment Benefits to Potential Harm. JAMA. 2018;320(17):1760-3. doi: 10.1001/jama.2018.16068. [PubMed: 30398583].
  12. Forouzanfar MH, Liu P, Roth GA; et al. Global burden of hypertension and systolic blood pressure of at least 110 to 115 mm hg, 1990-2015. JAMA. 2017;317(2):165-82. doi: 10.1001/jama.2016.19043.
  13. Kishore SP, Salam A, Rodgers A, Jaffe MG, Frieden T. Fixed-dose combinations for hypertension. The Lancet. 2018;392(10150):819-20. doi: 10.1016/s0140-6736(18)31814-2.
  14. Hossein-nezhad A, Holick MF. Vitamin D for health: a global perspective. Mayo Clin Proc. 2013;88(7):720-55. doi: 10.1016/j.mayocp.2013.05.011. [PubMed: 23790560]. [PubMed Central: PMCPmc3761874].
  15. Beveridge LA, Struthers AD, Khan F, Jorde R, Scragg R, Macdonald HM, et al. Effect of Vitamin D Supplementation on Blood Pressure: A Systematic Review and Meta-analysis Incorporating Individual Patient Data. JAMA Intern Med. 2015;175(5):745-54. doi: 10.1001/jamainternmed.2015.0237. [PubMed: 25775274].
  16. Shu L, Huang K. Effect of vitamin D supplementation on blood pressure parameters in patients with vitamin D deficiency: a systematic review and meta-analysis. J Am Soc Hypertens. 2018;12(7):488-96. doi: 10.1016/j.jash.2018.04.009. [PubMed: 29776759].
  17. Wu SH, Ho SC, Zhong L. Effects of vitamin D supplementation on blood pressure. South Med J. 2010;103(8):729-37. doi: 10.1097/SMJ.0b013e3181e6d389. [PubMed: 20622727].
  18. Wyskida M, Wieczorowska-Tobis K, Chudek J. Prevalence and factors promoting the occurrence of vitamin D deficiency in the elderly. Postepy Hig Med Dosw (Online). 2017;71(0):198-204. [PubMed: 28345527].
  19. Yu JR, Lee SA, Lee JG, Seong GM, Ko SJ, Koh G, et al. Serum vitamin d status and its relationship to metabolic parameters in patients with type 2 diabetes mellitus. Chonnam Med J. 2012;48(2):108-15. doi: 10.4068/cmj.2012.48.2.108. [PubMed: 22977752]. [PubMed Central: PMC3434790].
  20. Chen WR, Liu ZY, Shi Y, Yin DW, Wang H, Sha Y, et al. Vitamin D and nifedipine in the treatment of Chinese patients with grades I-II essential hypertension: a randomized placebo-controlled trial. Atherosclerosis. 2014;235(1):102-9. doi: 10.1016/j.atherosclerosis.2014.04.011. [PubMed: 24942709].
  21. Gijon Conde T, Banegas JR. [Ambulatory blood pressure monitoring for hypertension diagnosis?]. Hipertens Riesgo Vasc. 2017;34 Suppl 1:4-9. Spanish. doi: 10.1016/s1889-1837(18)30056-4. [PubMed: 29703401].
  22. Craig CL, Marshall AL, Sjostrom M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-95. doi: 10.1249/01.mss.0000078924.61453.fb. [PubMed: 12900694].
  23. Shaygannejad V, Maljaei MB, Bank SS, Mirmosayyeb O, Maracy MR, Askari G. Association between Sun Exposure, Vitamin D Intake, Serum Vitamin D Level, and Immunoglobulin G Level in Patients with Neuromyelitis Optica Spectrum Disorder. Int J Prev Med. 2018;9:68. doi: 10.4103/ijpvm.IJPVM_45_16. [PubMed: 30167098]. [PubMed Central: PMCPmc6106131].
  24. Hajhashemi M, Khorsandi A. Comparison of sun exposure versus vitamin D supplementation for pregnant women with vitamin D deficiency. J Matern Fetal Neonatal Med. 2019;32(8):1347-52. doi: 10.1080/14767058.2017.1406470. [PubMed: 29141476].
  25. Pilz S, Gaksch M, Kienreich K, Grubler M, Verheyen N, Fahrleitner-Pammer A, et al. Effects of vitamin D on blood pressure and cardiovascular risk factors: a randomized controlled trial. Hypertension. 2015;65(6):1195-201. doi: 10.1161/hypertensionaha.115.05319. [PubMed: 25801871].
  26. Arora P, Song Y, Dusek J, Plotnikoff G, Sabatine MS, Cheng S, et al. Vitamin D therapy in individuals with prehypertension or hypertension: the DAYLIGHT trial. Circulation. 2015;131(3):254-62. doi: 10.1161/circulationaha.114.011732. [PubMed: 25359163].
  27. Nasri H, Behradmanesh S, Ahmadi A, Rafieian-Kopaei M. Impact of oral vitamin D (cholecalciferol) replacement therapy on blood pressure in type 2 diabetes patients; a randomized, double-blind, placebo controlled clinical trial. J Nephropathol. 2014;3(1):29-33. doi: 10.12860/jnp.2014.07. [PubMed: 24644541]. [PubMed Central: PMC3956905].
  28. Jafari T, Fallah AA, Barani A. Effects of vitamin D on serum lipid profile in patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Clin Nutr. 2016;35(6):1259-68. doi: 10.1016/j.clnu.2016.03.001. [PubMed: 27020528].
  29. Khosravi ZS, Kafeshani M, Tavasoli P, Zadeh AH, Entezari MH. Effect of Vitamin D Supplementation on Weight Loss, Glycemic Indices, and Lipid Profile in Obese and Overweight Women: A Clinical Trial Study. Int J Prev Med. 2018;9:63. doi: 10.4103/ijpvm.IJPVM_329_15. [PubMed: 30123437]. [PubMed Central: PMCPmc6071442].