{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:12:57Z","timestamp":1787008377868,"version":"build-2736575974"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,9,19]],"date-time":"2021-09-19T00:00:00Z","timestamp":1632009600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["7K23HL135273"],"award-info":[{"award-number":["7K23HL135273"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["U01AG047837"],"award-info":[{"award-number":["U01AG047837"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000063","name":"Office of Dietary Supplements","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000063","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019091","name":"Mid-Atlantic Nutrition Obesity Research Center","doi-asserted-by":"crossref","award":["P30DK072488"],"award-info":[{"award-number":["P30DK072488"]}],"id":[{"id":"10.13039\/100019091","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Johns Hopkins Institute for Clinical and Translation Research","award":["UL1TR003098"],"award-info":[{"award-number":["UL1TR003098"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vitamin D3 supplementation is considered a potential intervention to prevent orthostatic hypotension (OH) based on observational evidence that vitamin D levels are inversely associated with OH. With data from The Study to Understand Fall Reduction and Vitamin D in You (STURDY), a double-blind, randomized, response-adaptive trial, we determined if higher doses of vitamin D3 reduced risk of OH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>STURDY tested the effects of higher (1,000+ IU\/day, i.e., 1,000, 2,000, and 4,000 IU\/day combined) vs. lower-dose vitamin D3 (200 IU\/day, comparison) on fall risk in adults ages 70 years and older with low serum 25-hydroxyvitamin D (25(OH)D, 10\u201329 ng\/ml). OH was determined at baseline, 3, 12, and 24 months by taking the difference between seated and standing blood pressure (BP). OH was defined as a drop in systolic or diastolic BP of at least 20 or 10 mm Hg after 1 minute of standing. Participants were also asked about OH symptoms during the assessment and the preceding month.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 688 participants (mean age 77 [SD, 5] years; 44% women; 18% Black), the mean baseline systolic\/diastolic BP was 130 (19)\/67 (11) mm Hg, serum 25(OH)D was 22.1 (5.1) ng\/ml, and 2.8% had OH. There were 2,136 OH assessments over the maximum 2-year follow-up period. Compared with 200 IU\/day, 1,000+ IU\/day was not associated with seated, standing, or orthostatic BP, and it did not lower risk of OH or orthostatic symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings do not support use of higher doses of vitamin D3 supplementation as an intervention to prevent OH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trials registration<\/jats:title>\n                    <jats:p>Trial Number NCT02166333.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajh\/hpab147","type":"journal-article","created":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T15:16:20Z","timestamp":1631718980000},"page":"192-199","source":"Crossref","is-referenced-by-count":7,"title":["Effects of Vitamin D Supplementation on Orthostatic Hypotension: Results From the STURDY Trial"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4168-2696","authenticated-orcid":false,"given":"Stephen P","family":"Juraschek","sequence":"first","affiliation":[{"name":"Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Edgar R","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Johns Hopkins University School of Medicine, Johns Hopkins University , Baltimore, Maryland , USA"},{"name":"The Welch Center for Prevention, Epidemiology and Clinical Research , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal A","family":"Wanigatunga","sequence":"additional","affiliation":[{"name":"Center on Aging and Health, The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer A","family":"Schrack","sequence":"additional","affiliation":[{"name":"The Welch Center for Prevention, Epidemiology and Clinical Research , Baltimore, Maryland , USA"},{"name":"Center on Aging and Health, The Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin D","family":"Michos","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Johns Hopkins University School of Medicine, Johns Hopkins University , Baltimore, Maryland , USA"},{"name":"The Welch Center for Prevention, Epidemiology and Clinical Research , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine M","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Johns Hopkins University School of Medicine, Johns Hopkins University , Baltimore, Maryland , USA"},{"name":"The Welch Center for Prevention, Epidemiology and Clinical Research , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita R","family":"Kalyani","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Johns Hopkins University School of Medicine, Johns Hopkins University , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence J","family":"Appel","sequence":"additional","affiliation":[{"name":"Department of Medicine, The Johns Hopkins University School of Medicine, Johns Hopkins University , Baltimore, Maryland , USA"},{"name":"The Welch Center for Prevention, Epidemiology and Clinical Research , Baltimore, Maryland , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,9,19]]},"reference":[{"key":"2022100812004337700_CIT0001","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1161\/01.HYP.19.6.508","article-title":"Orthostatic hypotension in older adults. The Cardiovascular Health Study. CHS Collaborative Research Group","volume":"19","author":"Rutan","year":"1992","journal-title":"Hypertension"},{"key":"2022100812004337700_CIT0002","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/S0002-9343(99)00425-8","article-title":"The association between orthostatic hypotension and recurrent falls in nursing home residents","volume":"108","author":"Ooi","year":"2000","journal-title":"Am J Med"},{"key":"2022100812004337700_CIT0003","doi-asserted-by":"crossref","first-page":"e008884","DOI":"10.1161\/JAHA.118.008884","article-title":"Orthostatic hypotension and risk of clinical and subclinical cardiovascular disease in middle-aged adults","volume":"7","author":"Juraschek","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"2022100812004337700_CIT0004","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.archger.2014.03.008","article-title":"Does vitamin D deficiency increase orthostatic hypotension risk in the elderly patients?","volume":"59","author":"Soysal","year":"2014","journal-title":"Arch Gerontol Geriatr"},{"key":"2022100812004337700_CIT0005","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1111\/joim.12201","article-title":"Vitamin D deficiency is associated with orthostatic hypotension in oldest-old women","volume":"276","author":"Annweiler","year":"2014","journal-title":"J Intern Med"},{"key":"2022100812004337700_CIT0006","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1111\/jch.13996","article-title":"Associations of the systolic and diastolic components of orthostatic hypotension with markers of cardiovascular risk in older men: a cross-sectional analysis from The British Regional Heart Study","volume":"22","author":"Gilani","year":"2020","journal-title":"J Clin Hypertens (Greenwich)"},{"key":"2022100812004337700_CIT0007","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1007\/s12603-016-0857-0","article-title":"Vitamin D and the mechanisms, circumstances and consequences of falls in older adults: a case-control study","volume":"21","author":"Duval","year":"2017","journal-title":"J Nutr Health Aging"},{"key":"2022100812004337700_CIT0008","doi-asserted-by":"crossref","first-page":"1036","DOI":"10.1097\/HJH.0000000000000907","article-title":"Hypovitaminosis D and orthostatic hypotension: a systematic review and meta-analysis","volume":"34","author":"Ometto","year":"2016","journal-title":"J Hypertens"},{"key":"2022100812004337700_CIT0009","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1172\/JCI0215219","article-title":"1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system","volume":"110","author":"Li","year":"2002","journal-title":"J Clin Invest"},{"key":"2022100812004337700_CIT0010","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1016\/j.jsbmb.2004.03.004","article-title":"Vitamin D: a negative endocrine regulator of the renin-angiotensin system and blood pressure","volume":"89\u201390","author":"Li","year":"2004","journal-title":"J Steroid Biochem Mol Biol"},{"key":"2022100812004337700_CIT0011","doi-asserted-by":"crossref","first-page":"E565","DOI":"10.3390\/nu8090565","article-title":"Relationship between vitamin D status and autonomic nervous system activity","volume":"8","author":"Burt","year":"2016","journal-title":"Nutrients"},{"key":"2022100812004337700_CIT0012","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1161\/HYPERTENSIONAHA.115.05688","article-title":"Vitamin D supplementation is associated with stabilization of cardiac autonomic tone in IgA nephropathy","volume":"66","author":"Mann","year":"2015","journal-title":"Hypertension"},{"key":"2022100812004337700_CIT0013","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1097\/HJH.0000000000000223","article-title":"Effect of vitamin D supplementation on orthostatic hypotension: data from the vitamin D in isolated systolic hypertension randomized controlled trial","volume":"32","author":"Witham","year":"2014","journal-title":"J Hypertens"},{"key":"2022100812004337700_CIT0014","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.cct.2018.08.004","article-title":"Rationale and design of the Study To Understand Fall Reduction and Vitamin D in You (STURDY): a randomized clinical trial of vitamin D supplement doses for the prevention of falls in older adults","volume":"73","author":"Michos","year":"2018","journal-title":"Contemp Clin Trials"},{"key":"2022100812004337700_CIT0015","doi-asserted-by":"crossref","first-page":"145","DOI":"10.7326\/M20-3812","article-title":"The effects of four doses of vitamin D supplements on falls in older adults: a response-adaptive, randomized clinical trial","volume":"174","author":"Appel","year":"2021","journal-title":"Ann Intern Med"},{"key":"2022100812004337700_CIT0016","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/BF02291236","article-title":"Consensus statement on the definition of orthostatic hypotension, pure autonomic failure and multiple system atrophy","volume":"6","author":"Kaufmann","year":"1996","journal-title":"Clin Auton Res"},{"key":"2022100812004337700_CIT0017","doi-asserted-by":"crossref","first-page":"g2035","DOI":"10.1136\/bmj.g2035","article-title":"Vitamin D and multiple health outcomes: umbrella review of systematic reviews and meta-analyses of observational studies and randomised trials","volume":"348","author":"Theodoratou","year":"2014","journal-title":"BMJ"},{"key":"2022100812004337700_CIT0018","first-page":"633","article-title":"Effects of vitamin D supplementation on 25(OH)D concentrations and blood pressure in the elderly: a systematic review and meta-analysis","volume":"9","author":"Farapti","year":"2020","journal-title":"F1000Res"},{"key":"2022100812004337700_CIT0019","doi-asserted-by":"crossref","first-page":"3109294","DOI":"10.1155\/2021\/3109294","article-title":"Calcitriol supplementation ameliorates microvascular endothelial dysfunction in vitamin D-deficient diabetic rats by upregulating the vascular eNOS protein expression and reducing oxidative stress","volume":"2021","author":"Wee","year":"2021","journal-title":"Oxid Med Cell Longev"},{"key":"2022100812004337700_CIT0020","article-title":"Low vitamin D levels are associated with vascular endothelial dysfunction in patients with poorly controlled type 2 diabetes: a retrospective study","author":"Tanaka","year":"2021","journal-title":"J Atheroscler Thromb"},{"key":"2022100812004337700_CIT0021","doi-asserted-by":"crossref","first-page":"986","DOI":"10.1161\/HYPERTENSIONAHA.118.11337","article-title":"Hypertension treatment effects on orthostatic hypotension and its relationship with cardiovascular disease","volume":"72","author":"Juraschek","year":"2018","journal-title":"Hypertension"},{"key":"2022100812004337700_CIT0022","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1161\/HYPERTENSIONAHA.119.14309","article-title":"Orthostatic hypotension, cardiovascular outcomes, and adverse events: results from SPRINT","volume":"75","author":"Juraschek","year":"2020","journal-title":"Hypertension"},{"key":"2022100812004337700_CIT0023","doi-asserted-by":"crossref","first-page":"58","DOI":"10.7326\/M20-4298","article-title":"Effects of intensive blood pressure treatment on orthostatic hypotension: a systematic review and individual participant-based meta-analysis","volume":"174","author":"Juraschek","year":"2021","journal-title":"Ann Intern Med"},{"key":"2022100812004337700_CIT0024","doi-asserted-by":"crossref","first-page":"897","DOI":"10.2147\/CIA.S81283","article-title":"Uncontrolled hypertension and orthostatic hypotension in relation to standing balance in elderly hypertensive patients","volume":"10","author":"Shen","year":"2015","journal-title":"Clin Interv Aging"},{"key":"2022100812004337700_CIT0025","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.1532-5415.2011.03317.x","article-title":"Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study","volume":"59","author":"Gangavati","year":"2011","journal-title":"J Am Geriatr Soc"},{"key":"2022100812004337700_CIT0026","doi-asserted-by":"crossref","first-page":"e1941","DOI":"10.1212\/WNL.0000000000010456","article-title":"Orthostatic hypotension, dizziness, neurology outcomes, and death in older adults","volume":"95","author":"Juraschek","year":"2020","journal-title":"Neurology"}],"container-title":["American Journal of Hypertension"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ajh\/advance-article-pdf\/doi\/10.1093\/ajh\/hpab147\/41010174\/hpab147.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/35\/2\/192\/46382242\/hpab147.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/35\/2\/192\/46382242\/hpab147.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T08:01:11Z","timestamp":1665216071000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajh\/article\/35\/2\/192\/6372426"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,19]]},"references-count":26,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,9,19]]},"published-print":{"date-parts":[[2022,2,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ajh\/hpab147","relation":{},"ISSN":["0895-7061","1941-7225"],"issn-type":[{"value":"0895-7061","type":"print"},{"value":"1941-7225","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,2,1]]},"published":{"date-parts":[[2021,9,19]]}}}