{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T06:27:26Z","timestamp":1758349646803,"version":"3.44.0"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Even though substantial evidence has found that vitamin D deficiency correlates to risk factors for cardiovascular disease (CVD), few studies have shown how vitamin D affects coronary revascularization and heart rate variability (HRV). We aimed to explore the connection between vitamin D levels with coronary revascularization and HRV in hypertensive patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of the 250 eligible participants with hypertension hospitalized at the Department of Cardiology, Sixth Medical Center of Chinese PLA General Hospital was consecutively recruited. The status of vitamin D is measured utilizing serum 25-hydroxyvitamin D<jats:sub>3<\/jats:sub> [25(OH)D<jats:sub>3<\/jats:sub>] concentrations. The primary endpoints were defined as patients undergoing coronary revascularization treatment. The secondary endpoints were defined as the variation in HRV. HRV indices were recorded in participants using a 24-h Holter electrocardiogram (ECG). In addition, direct renin concentrations and plasma aldosterone concentrations were measured in the supine and standing positions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the study, 165 eligible patients assigned to the vitamin D deficiency [25(OH)D<jats:sub>3<\/jats:sub>\u2009&amp;lt;\u200920\u2005ng\/ml] group and 85 to the vitamin D non-deficiency[25(OH)D<jats:sub>3<\/jats:sub>\u2009\u2265\u200920\u2005ng\/ml] group. In both univariate logistic regression analysis (OR: 2.46, 95% CI: 1.06\u20135.68; <jats:italic>P<\/jats:italic>\u2009=\u20090.036) and multivariate logistic regression analysis (OR: 2.54, 95% CI: 1.02\u20136.33; <jats:italic>P<\/jats:italic>\u2009=\u20090.046), the 25(OH)D<jats:sub>3<\/jats:sub>\u2009&amp;lt;\u200920\u2005ng\/ml demonstrated to be a significant risk factor of primary endpoints for those hypertensive patients. Receiver operating characteristic curve (ROC) analysis showed the multivariable-adjusted model for predicting primary endpoints in patients with hypertension, with an area under the curve (AUC) of 0.73 (95% CI: 0.64\u20130.82, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001). Regarding secondary endpoints, the HRV indexes such as standard deviation of normal-to-normal (NN) intervals (SDNN) (<jats:italic>P<\/jats:italic>\u2009=\u20090.04), standard deviation of the averages of NN intervals in all 5-min segments (SDANN) (<jats:italic>P<\/jats:italic>\u2009=\u20090.03), and Triangle indexes values (<jats:italic>P<\/jats:italic>\u2009=\u20090.02) were significantly different in the two groups. Finally, we observed that hypertensive patients with vitamin D deficiency had significantly greater aldosterone and aldosterone-to-renin ratio (ARR) values than those having vitamin D non-deficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Vitamin D deficiency was prevalent in hypertensive patients and was independently associated with the risk of coronary revascularization. Vitamin D deficiency also affects HRV and ARR values in hypertensive patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fcvm.2025.1590701","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T05:30:07Z","timestamp":1758259807000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of vitamin D with coronary revascularization and heart rate variability in hypertensive 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