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"Pain. Joints. Spine." 1 (21) 2016

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Efficacy of correcting vitamin D deficiency/insufficiency in women with arterial hypertension in premenopausal and early postmenopausal periods

Authors: Kezhun L.V., Yankovskaya L.V. - Educational Establishment «Grodno State Medical University», Grodno, Belarus

Categories: Rheumatology, Traumatology and orthopedics

Sections: Medical forums

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The article was published on p. 74

 

Background. Vitamin D deficiency/insufficiency and its correcting is an actual problem of today. It is due to both high incidence of vitamin D deficiency in the general population varying from 70 % tо 96.8 % and its relationship with cardiovascular pathology, particularly arterial hypertension (AH) in postmenopausal women [1, 2].

Aim. To assess the serum level of 25(ОН)D in women with AH in premenopausal and early postmenopausal periods as well as to evaluate the efficacy of its correction.
Materials and methods. We investigated 102 women with AH stage II risk 3 aged 50 (48, 53) years: of these 50 females in premenopausal period — group I and 52 females in early postmenopausal period — group II. Using the immunoenzymatic assay we determined the serum level of 25(OH)D total including 25(OH)D2 and 25(OH)D3. 
According to the serum level of 25(OH)D in female patients in groups I and II we identified the subgroups with its deficiency/insufficiency: subgroup IB (n = 25) and subgroup IIB (n = 21) respectively. In these subgroups the algorithm of antihypertensive therapy (ramipril and indapamide) was supplemented with cholecalciferol (Aquadetrim, Poland) at a daily dose of 2.000 IU for 3 months. In subgroups IА (n = 25) and IIА (n = 31) without vitamin D deficiency cholecalciferol was not administered. Statistical analysis was performed using STATISTICA 10.0 software package.
Results. At baseline the serum level of 25(OH)D was lower (p < 0.05) in subgroups IB (19.3 ± 8.5 ng/ml) and IIB (18.2 ± 9.5 ng/ml) than in the comparable subgroups IА (26.7 ± 11.5 ng/ml) and IIА (27.4 ± 10.5 ng/ml). In subgroup IB 60 % of women had vitamin D deficiency, and 40 % demonstrated vitamin D insufficiency. In subgroup IIB 61.9 % of women had vitamin D deficiency, 38.1 % showed insufficiency. After 3 months of cholecalciferol therapy in subgroup IB the serum level of 25(OH)D increased significantly (p = 0.0001) and was 37.28 ± 11.97 ng/ml; it became higher (p = 0.001) than in subgroup IA. In subgroup IIB the serum level of 25(OH)D increased (p = 0.004) as well and made 36.4 ± 10.0 ng/ml; it also became higher (p = 0.007) than in subgroup IIA. Optimal level of serum 25(OH)D was achieved in 80 % of women in subgroup IB and 76.2 % women in subgroup IIB. The level of serum 25(OH)D remained insufficient in 12 % patients from subgroup IB and 14.3 % patients from subgroup IIB, 25(OH)D deficiency was observed in 8 and 9.5 % of patients respectively.
Conclusion. Women with AH stage II in premenopausal and early postmenopausal periods demonstrated high incidence of vitamin D deficiency/insufficiency — 76.5 %. Cholecalciferol therapy at a daily dose of 2.000 IU lasting for three months efficiently corrects serum vitamin D deficiency/insufficiency and allows to obtain its optimal level in 80 % of women with AH in premenopausal period and 76.2 % of women in early postmenopausal period.

Bibliography

1. Pérez-López F.R. Vitamin D metabolism and cardiovascular risk factors in postmenopausal women // Maturitas. — 2009. — Vol. 62, № 3. — Р. 248-262.
 
2. Relation of vitamin D deficiency to cardiovascular risk factors, disease status, and incident events in a general healthcare population / J. L. Anderson et al. // Am. J. Cardiol. — 2010. — Vol. 106. — P. 963-968.   

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