Lower diastolic blood pressure in healthy subjects with vitamin K deficiency: a preliminary cross-sectional study
AbstractIntroduction. There is a growing body of evidence for the role of vitamin K in cardiovascular health. As a cofactor of carboxylation of the matrix Gla protein it prevents arterial calcification. However, the data on the relationship between vitamin K status and the blood pressure are scarce, and particularly so in persons without the burden of cardiovascular risk factors. Material and Methods. We performed a pilot cross-sectional study, in which we hypothesized that vitamin K deficiency is associated with a higher blood pressure in young, healthy people. The concentration of protein induced by vitamin K absence-II (PIVKA-II) larger than 2 ng/mL was chosen as a proxy for vitamin K deficiency; it was assessed in serum using ELISA. Blood pressure was measured using a validated, automated oscillometric monitor in triplicate.Results. Twenty-three healthy subjects were enrolled (16 female; mean age 21.3 ± 1.6 years; body mass index 20.6 ± 2.4 kg/m2). The diastolic blood pressure (DBP) was lower in vitamin K-deficient subjects (58 ± 9 vs. 67 ± 5 mmHg, p = 0.01). The mean arterial blood pressure also differed (75 ± 9 vs. 83 ± 6, p = 0.02). PIVKA-II levels correlated with DBP only (Pearson’s R = -0.41, p < 0.05; Spearman’s ? ns.). Stepwise regression identified PIVKA-II concentrations as the only independent parameter associated with DBP (adjusted R2 = 13.1%; PIVKA-II: ß = -0.41; 95%CI -1.87-(-0.00098), t = -2.08, p < 0.05).Conclusions. The relationship between vitamin K deficiency and low DBP in young adults should be investigated further.
Pivin E, Ponte B, Pruijm M, Ackermann D, Guessous I, Ehret G et al. Inactive Matrix Gla-Protein Is Associated With Arterial Stiffness in an Adult Population-Based Study. Hypertens Dallas Tex. 2015;66:85–92.
Cundiff DK, Agutter PS. Cardiovascular Disease Death Before Age 65 in 168 Countries Correlated Statistically with Biometrics, Socioeconomic Status, Tobacco, Gender, Exercise, Macronutrients, and Vitamin K. Cureus. 2016;8:e748.
Madry E, Nowak J, Wykretowicz A, Wenska-Chyzy E, Miskiewicz-Chotnicka A, Walkowiak J. Predicting the risk of atherosclerosis in patients with cystic fibrosis – rationale and design of a prospective cohort study. J Med Sci. 2015;84:126–128.
El Assaad MA, Topouchian JA, Asmar RG. Evaluation of two devices for self-measurement of blood pressure according to the international protocol: the Omron M5-I and the Omron 705IT. Blood Press Monit. 2003;8:127–133.
Omboni S, Riva I, Giglio A, Caldara G, Groppelli A, Parati G. Validation of the Omron M5-I, R5-I and HEM-907 automated blood pressure monitors in elderly individuals according to the International Protocol of the European Society of Hypertension. Blood Press Monit. 2007;12:233–242.
Lim MA, Shafique S, See SY, Khan FN, Parikh CR, Peixoto AJ. Effects of warfarin on blood pressure in men with diabetes and hypertension--a longitudinal study. J Clin Hypertens Greenwich Conn. 2007;9:256–258.
Kallistratos MS, Manolis AJ, Mancia G. Blood pressure. The forgotten factor in previous and recent studies regarding anticoagulation in atrial fibrillation. Int J Cardiol. 2013;168:4434–4435.
Essalihi R, Dao HH, Yamaguchi N, Moreau P. A new model of isolated systolic hypertension induced by chronic warfarin and vitamin K1 treatment. Am J Hypertens. 2003;16:103–110.
Ware KM, Vance JC, Muni N, Hebert LA, Satoskar AA, Nadasdy G et al. Oral warfarin and the thrombin inhibitor dabigatran increase blood pressure in rats: hidden danger of anticoagulants? Am J Hypertens. 2015;28:182–189.
McCabe KM, Booth SL, Fu X, Shobeiri N, Pang JJ, Adams MA et al. Dietary vitamin K and therapeutic warfarin alter the susceptibility to vascular calcification in experimental chronic kidney disease. Kidney Int. 2013;83:835–844.
Rennenberg RJMW, de Leeuw PW, Kessels AGH, Schurgers LJ, Vermeer C, van Engelshoven JMA et al. Calcium scores and matrix Gla protein levels: association with vitamin K status. Eur J Clin Invest. 2010;40:344–349.
Knapen MHJ, Braam LAJLM, Drummen NE, Bekers O, Hoeks APG, Vermeer C. Menaquinone-7 supplementation improves arterial stiffness in healthy postmenopausal women. A double-blind randomised clinical trial. Thromb Haemost. 2015;113:1135–1144.
Vossen LM, Schurgers LJ, van Varik BJ, Kietselaer BLJH, Vermeer C, Meeder JG et al. Menaquinone-7 Supplementation to Reduce Vascular Calcification in Patients with Coronary Artery Disease: Rationale and Study Protocol (VitaK-CAC Trial). Nutrients. 2015;7:8905–8915.
Fulton RL, McMurdo MET, Hill A, Abboud RJ, Arnold GP, Struthers AD et al. Effect of Vitamin K on Vascular Health and Physical Function in Older People with Vascular Disease--A Randomised Controlled Trial. J Nutr Health Aging. 2016;20:325–333.
Dalmeijer GW, van der Schouw YT, Magdeleyns E, Ahmed N, Vermeer C, Beulens JWJ. The effect of menaquinone-7 supplementation on circulating species of matrix Gla protein. Atherosclerosis. 2012;225:397–402.
Koitaya N, Ezaki J, Nishimuta M, Yamauchi J, Hashizume E, Morishita K et al. Effect of low dose vitamin K2 (MK-4) supplementation on bio-indices in postmenopausal Japanese women. J Nutr Sci Vitaminol (Tokyo). 2009;55:15–21.
Karl JP, Fu X, Wang X, Zhao Y, Shen J, Zhang C et al. Fecal menaquinone profiles of overweight adults are associated with gut microbiota composition during a gut microbiota-targeted dietary intervention. Am J Clin Nutr. 2015;102:84–93.
Pan Y, Jackson RT. Dietary phylloquinone intakes and metabolic syndrome in US young adults. J Am Coll Nutr. 2009;28:369–379.
Van Ballegooijen A, Van Schoor N, Brouwer I, Visser M, Beulens J. OS 06–09 the synergistic association between vitamin D and vitamin K with incident hypertension. J Hypertens. 2016;34(Suppl 1):e64.
Pivin E, Pruijm M, Ackermann D, Guessous I, Ehret G, Pechere-Bertschi A et al. 1D.03: Inactive matrix GLA protein is associated with renal resistive index in a population-based study. J Hypertens. 2015;33(Suppl 1):e15.
Button KS, Ioannidis JPA, Mokrysz C, Nosek BA, Flint J, Robinson ESJ et al. Power failure: why small sample size undermines the reliability of neuroscience. Nat Rev Neurosci. 2013;14:365–376.