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Association between non-dipper hypertension and vitamin D deficiency in women with systemic lupus erythematosus

1, 2, 3, 4

  1. Systemic Autoimmune Diseases Unit, Department of Internal Medicine, University Hospital Virgen de las Nieves, Granada, Spain. jomasabio@gmail.com
  2. Systemic Autoimmune Diseases Unit, Department of Internal Medicine, University Hospital Virgen de las Nieves, Granada, Spain.
  3. Department of Internal Medicine, University Hospital Virgen de las Nieves, Granada, Spain.
  4. Hypertension and Lipids Unit, Department of Internal Medicine, University Hospital Virgen de las Nieves, Granada, Spain.

CER11255 Submission on line
2019 Vol.37, N°2 - PI 0286, PF 0292
Full Papers

Rheumatology Article

 

Abstract

OBJECTIVES:
Blood pressure (BP) physiologically declines more than 10% at night. Subjects who do not experience this drop are classified as non-dippers. They have a higher risk of cardiovascular diseases (CVD). Vitamin D deficiency and non-dipper pattern have been associated in the general population. Patients with systemic lupus erythematosus (SLE) are more likely to have vitamin D deficiency, a non-dipper pattern and CVD. We aimed to evaluate a possible relationship between vitamin D deficiency and non-dipper pattern in patients with SLE.
METHODS:
Using 24-hour ambulatory BP monitoring, 77 women with SLE were divided into dippers and non-dippers. 25-hydroxyvitamin D (25(OH)D) levels were compared between both groups. A multivariate analysis was used to determine which variables were independently associated with non-dipper pattern.
RESULTS:
62% of patients were non-dippers. They had lower levels of 25(OH)D than dippers (19.4±8.9 vs. 25.9±10.1 ng/ml, p=0.005). Patients with lower 25(OH)D levels were more likely to be non-dippers (OR 3.7, 95%CI 1.2–11.4; p=0.025). The nocturnal decline of mean BP correlated with levels of 25(OH)D (r=0.227, p=0.047). Night-time systolic, diastolic and mean BP inversely correlated with the levels of 25(OH)D (r=-0.274, p=0.016; r=-0.238, p=0.037, and r=-0.260, p=0.022, respectively), but only night- time systolic BP remained significant after adjustment for age and body mass index (r=-0.228, p=0.049). 25(OH)D levels and the use of mycophenolate were found to be independently associated with non-dipper pattern in SLE patients.
CONCLUSIONS:
Vitamin D deficiency may contribute to the development of a non-dipper pattern in patients with SLE.

PMID: 30183606 [PubMed]

Received: 18/03/2018 - Accepted : 04/06/2018 - In Press: 29/08/2018 - Published: 19/03/2019