CONCLUSION Our meta- analysis highlights that hypovitaminosis D is associated with orthostatic hypotension , independent of potential confounders .
OBJECTIVES Orthostatic hypotension is a common condition among older adults and is associated with a range of deleterious outcomes .
Recently , interest has developed in hypovitaminosis D ( defined as low 25 hydroxiyvitamin D levels ) as a potential risk factor for orthostatic hypotension .
We conducted a systematic review and meta- analysis examining the association of orthostatic hypotension between study participants with and without hypovitaminosis D , including the adjustment of potential confounders ( age , sex , BMI , renal function , comorbidities , seasonality , use of antihypertensive medications , and supplementation with cholecalciferol ) .
Plasma 1,25-Dihydroxyvitamin D and the Risk of Developing Hypertension: The Prevention of Renal and Vascular End-Stage Disease Study
Previous observational studies on the vascular effects of vitamin D have predominantly relied on measurement of its inactive precursor , 25-hydroxyvitamin D , whereas the active metabolite 1,25-dihydroxyvitamin D may be of more physiological relevance . We prospect ively studied the associations of 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D with  hypertension risk ( blood pressure ≥140/90 mm Hg or initiation of blood pressure – lowering drugs ) in 5066 participants aged 28 to 75 years , free of hypertension at baseline from the Prevention of Renal and Vascular End-Stage Disease Study , a well-defined cohort with serial follow-up . We measured plasma 1,25-dihydroxyvitamin D and 25-hydroxyvitamin D using liquid chromatography-t and em mass spectrometry .  Mean±SD plasma concentration of 1,25-dihydroxyvitamin  D was 145±47.0 pmol/L and 25-hydroxyvitamin D was 58.6±23.8 nmol/L. During a median follow-up of 6.4 years , 1036 participants ( 20.5 % ) developed hypertension . As expected , low 25-hydroxyvitamin D was associated with a higher hypertension risk ; each 1-SD decrement in 25-hydroxyvitamin D was associated with a 8 % higher hypertension risk ( hazard ratio , 1.08 ; 95 % confidence interval , 1.01–1.16 ) after adjustment for potential confounders . However , the association of 1,25-dihydroxyvitamin D was in the opposite direction ; each 1-SD decrement of 1,25-dihydroxyvitamin D was associated with a 10 % lower hypertension risk ( hazard ratio , 0.90 ; 95 % confidence interval , 0.84–0.96 ) , independent of potential confounders . In contrast to the inverse association between 25-hydroxyvitamin D and hypertension risk , 1,25-dihydroxyvitamin D was positively associated with risk of hypertension . Thus , higher circulating concentrations of 1,25-dihydroxyvitamin D are associated with a higher risk of hypertension
CONCLUSION Our meta- analysis highlights that hypovitaminosis D is associated with orthostatic hypotension , independent of potential confounders .
OBJECTIVES Orthostatic hypotension is a common condition among older adults and is associated with a range of deleterious outcomes .
Recently , interest has developed in hypovitaminosis D ( defined as low 25 hydroxiyvitamin D levels ) as a potential risk factor for orthostatic hypotension .
We conducted a systematic review and meta- analysis examining the association of orthostatic hypotension between study participants with and without hypovitaminosis D , including the adjustment of potential confounders ( age , sex , BMI , renal function , comorbidities , seasonality , use of antihypertensive medications , and supplementation with cholecalciferol ) .