Hypertension L), and insufficiency is defined as

Hypertension is a chronic
disease in which the blood vessels have persistently raised pressure and putting
them under increased stress.

Normal adult blood
pressure is defined as a blood pressure of 120 mm Hg when the heart beats (systolic) and a
blood pressure of 80 mm Hg when the heart relaxes (diastolic). When systolic
blood pressure is equal to or above 140 mm Hg and/or a diastolic blood pressure
equal to or above 90 mm Hg, the blood pressure is considered to be high. (1)

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Hypertension is the most common condition seen in primary care and
leads to myocardial infarction, stroke, renal failure, and death if not
detected early and treated appropriately. (2)


Vitamin D is a fat-soluble vitamin that is naturally present in
very few foods, and available as a dietary supplement. Ultraviolet rays from
sunlight strike the skin and trigger vitamin D synthesis and production also. Vitamin
D promotes calcium absorption in
the gut and maintains adequate serum calcium and phosphate concentrations to
enable normal mineralization of bone and to prevent hypocalcemic tetany. It is
also needed for bone growth remodeling through osteoblasts and osteoclasts. (26)

In adults, vitamin D deficiency is defined as a serum
25-hydroxyvitamin D level of less than 20 ng per mL (50 nmol per L), and
insufficiency is defined as a serum 25-hydroxyvitamin D level of 20 to 30 ng
per mL (50 to 75 nmol per L). (3)


More than 1 in 5 adults
worldwide have raised blood pressure. (1) Prevalence of  hypertension is increasing in Saudi Arabia
affecting more than one fourth of the adult Saudi population. (4) A group of
international experts concluded that approximately 50 percent of persons 65
years and older in North America and 66 percent of persons internationally (all
ages) failed to maintain healthy bone density and tooth attachment because of
inadequate vitamin D levels. (3) In Saudi Arabia, over-all prevalence of vitamin D deficiency
in 2014 is 78.1% in females and 72.4% in males. (5)1.   McMullan CJ study (USA, 2016) conducted a double-blind
randomized control trial on 84 participants to assess the effect of vitamin D
on renin-angiotensin system activation and blood pressure level. It reported
that there was no benefit from correcting vitamin D deficiency on RAS activity.
(7) 2.   Salari A study (Iran, 2016) conducted a case-control study on 127
patients with newly recognized hypertension and the 120 normal participants to
assess the effect of nutritional intake, depressive symptoms and vitamin D
status in hypertensive patients. It reported that vitamin D status was lower in
the most individuals and it causes a considerable increase in the risk of
hypertension. (8) 3.   Beveridge LA study (Scotland, 2015) conducted a systematic review
and meta-analysis incorporating individual patient data to assess the effect of
vitamin D supplementation on blood pressure. It reported that there was the
Vitamin D supplementation  ineffective as
an agent for lowering BP and thus should not be used as an antihypertensive
agent. (9) 4.   Qi D study (China, 2017) conducted a randomized controlled clinical
trials, a systemic review and meta-analysis on total 917 participant to assess
the effect of vitamin D supplementation on hypertension in non-CKD populations
. It reported that vitamin D was not an antihypertensive agent although it has
a moderate SBP lowering effect. (10)     5.   Akbari R study (Iran, 2016 ) conducted a case-control study on 100
Participant to assess the Serum vitamin D in hypertensive patients versus
healthy controls . It found that serum 25-OHD level in cases was higher than
controls. The results contradict with earlier studies indicating an association
between vitamin D deficiency and HTN. (11)  6.   Arora P study (Birmingham, 2015) 
conducted a double-blind, randomized, controlled trial was conducted at
4 sites in the United States on 534 Participant 
to assess the effect of  Vitamin D
therapy in individuals with prehypertension or hypertension .  It reported that Vitamin D supplementation
did not reduce blood pressure in individuals with prehypertension or stage I
hypertension and vitamin D deficiency. (12) 7.   Godala M study (Poland, 
2016) conducted on  268 participants
to assess the plasma 25(OH)D vitamin deficiency in patients with metabolic
syndrome. It reported that plasma 25(OH)D vitamin deficiency was very high in
patients with metabolic syndrome, especially in men, people over 55 years and
during winter months. (13)   8.   Mojto V study (Bratislava, 2016 ) conducted  on  92
adult participants  to assess the non-skeletal
effects of vitamin D3 and the threshold limit associated with the risk of
health complications.  It reported that
the limit value of vitamin D3, 16 ng/ml, confirmed the association between
vitamin D3 insufficiency and the presence of hypertension, ischemic heart
disease, renal insufficiency and diabetes mellitus. (14) 9.   Nargesi AA study (Iran, 2016) conducted a study type cohort on  1586 patients 
to assess the Contribution of vitamin D deficiency to the risk of
coronary heart disease in subjects with essential hypertension. It reported
that the serum 25-Hydroxy-Vitamin-D is independently associated with future
hard CHD events and improves its prediction in patients with essential
hypertension. (15) 10.              
Shin JH
study (Korea, 2015)  conducted a  analyzed data from the Korean National Health
and Nutrition Examination Survey 5 database on 4107 postmenopausal  women to assess the vitamin D deficiency and
Its relationship to hypertension in postmenopausal Korean women. It found that
vitamin D deficiency 25(OH)D