This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Vitamin D deficiency is associated with diabetes and hypertension. Vitamin D replacement in vitamin D deficient subjects improves insulin action and decreases blood pressure. However, there is lack of evidence whether vitamin D replacement decreases blood pressure in hypertensive-diabetics patients with vitamin D deficiency. In addition there are no studies in this population that support the beneficial vascular effecvts of vitamin D replacement on vascular blood flow, blood pressure related hormones and inflammatory factors associated with vascular disease. To test these hypotheses we will enroll 25 Type 2 diabetic patients between the ages of 30 to 80 with 25 (OH) vitamin D levels 20 ng/ml of both sexes and of all ethnic groups with recent diagnosis of mild-moderate increased blood pressure who are not taking blood pressure medications. The experiment will be conducted in 2 steps, with subjects acting as their own controls. Patients will start on placebo and calcium carbonate 1.2 g/day for two weeks (step one) followed by vitamin D2 50,000 units twice a week orally for 5 weeks (step two). Plasma 25 (OH) vitamin D level will be measured after 5 weeks of vitamin replacement. We will consider adequate supplementation to be plasma 25 (OH) vitamin D level above 30 ng/ml. 24-hour ambulatory blood pressure, blood samples and arterial blood flow will be evaluated at baseline, after placebo and after acheiving normal 25 (OH) vitamin D levels. This information could provide greater understanding of the high incidence of cardiovascular disease in diabetics, and a possible new therapeutic target to reduce hypertension an dtherfore cardiac risk.
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