Introduction: This study was conducted to evaluate the effect of short-term sunlight exposure on blood pressure (BP) and pulse rate (PR) in vitamin D3-insufficient, prehypertensive patients. Methods: Twenty prehypertensive male participants were prospectively enrolled in this pilot study. BP and PR were measured using 24-hour ambulatory BP monitoring and endocrine biomarkers were assessed. Results: Sunlight exposure decreased 24-hour systolic BP (SBP), diastolic BP (DBP), and PR (SBP: 132.6 mm Hg to 129.3 mm Hg, DBP: 77.6 mm Hg to 75.7 mm Hg, and PR: 76.1 bpm to 71.3 bpm, p values: 0.0011, 0.0012, and <0.0001, respectively). The decrement patterns of SBP, DBP, and PR during nighttime (SBP: 123.5 mm Hg to 117.9 mm Hg, DBP: 72.2 mm Hg to 68.0 mm Hg, and PR: 68.2 bpm to 59.1 bpm, p values: 0.0015, 0.0003, and <0.0001, respectively) were more profound compared between daytime and nighttime. Blood levels of 25-hydroxyvitamin D3 were significantly increased (p = 0.0001) but aldosterone levels were significantly decreased (p = 0.0014) after sunlight exposure. In addition, an inverse relationship between 25-hydroxyvitamin D3 and aldosterone levels was observed (R = –0.4709, p = 0.0419). Discussion/Conclusion: The pilot study gives promising results that it is worthwhile to evaluate short-term sunlight exposure as a potentially effective approach in decreasing BP and PR in 25-hydroxyvitamin D3-insufficient prehypertensive patients in a larger trial with a control group.

1.
Weller
RB
.
Sunlight Has Cardiovascular Benefits Independently of Vitamin D
.
Blood Purif
.
2016
;
41
(
1-3
):
130
4
.
[PubMed]
0253-5068
2.
Grant
WB
.
Vitamin D reduces risk of cardiovascular disease.
2019
.
3.
Scragg
R
,
Rahman
J
,
Thornley
S
.
Association of sun and UV exposure with blood pressure and cardiovascular disease: A systematic review
.
J Steroid Biochem Mol Biol
.
2018
.
[PubMed]
0960-0760
4.
Rostand
SG
,
McClure
LA
,
Kent
ST
,
Judd
SE
,
Gutiérrez
OM
.
Associations of blood pressure, sunlight, and vitamin D in community-dwelling adults
.
J Hypertens
.
2016
Sep
;
34
(
9
):
1704
10
.
[PubMed]
0263-6352
5.
Krause
R
,
Bühring
M
,
Hopfenmüller
W
,
Holick
MF
,
Sharma
AM
.
Ultraviolet B and blood pressure
.
Lancet
.
1998
Aug
;
352
(
9129
):
709
10
.
[PubMed]
0140-6736
6.
Brennan
PJ
,
Greenberg
G
,
Miall
WE
,
Thompson
SG
.
Seasonal variation in arterial blood pressure
.
Br Med J (Clin Res Ed)
.
1982
Oct
;
285
(
6346
):
919
23
.
[PubMed]
0267-0623
7.
Rostand
SG
.
Ultraviolet light may contribute to geographic and racial blood pressure differences.
Hypertension (Dallas, Tex : 1979).
1997
;30(2 Pt 1):150-6.
8.
Law
MR
,
Morris
JK
.
Why is mortality higher in poorer areas and in more northern areas of England and Wales?
J Epidemiol Community Health
.
1998
Jun
;
52
(
6
):
344
52
.
[PubMed]
0143-005X
9.
Kloner
RA
,
Poole
WK
,
Perritt
RL
.
When throughout the year is coronary death most likely to occur? A 12-year population-based analysis of more than 220 000 cases
.
Circulation
.
1999
Oct
;
100
(
15
):
1630
4
.
[PubMed]
0009-7322
10.
Opländer
C
,
Volkmar
CM
,
Paunel-Görgülü
A
,
van Faassen
EE
,
Heiss
C
,
Kelm
M
, et al.
Whole body UVA irradiation lowers systemic blood pressure by release of nitric oxide from intracutaneous photolabile nitric oxide derivates
.
Circ Res
.
2009
Nov
;
105
(
10
):
1031
40
.
[PubMed]
0009-7330
11.
Almirall
J
,
Vaqueiro
M
,
Baré
ML
,
Anton
E
.
Association of low serum 25-hydroxyvitamin D levels and high arterial blood pressure in the elderly
.
Nephrol Dial Transplant
.
2010
Feb
;
25
(
2
):
503
9
.
[PubMed]
0931-0509
12.
He
S
,
Hao
X
.
The effect of vitamin D3 on blood pressure in people with vitamin D deficiency: A system review and meta-analysis
.
Medicine (Baltimore)
.
2019
May
;
98
(
19
):
e15284
.
[PubMed]
0025-7974
13.
Pfeifer
M
,
Begerow
B
,
Minne
HW
,
Nachtigall
D
,
Hansen
C
.
Effects of a short-term vitamin D(3) and calcium supplementation on blood pressure and parathyroid hormone levels in elderly women
.
J Clin Endocrinol Metab
.
2001
Apr
;
86
(
4
):
1633
7
.
[PubMed]
0021-972X
14.
Meems
LM
,
de Borst
MH
,
Postma
DS
,
Vonk
JM
,
Kremer
HP
,
Schuttelaar
ML
, et al.
Low levels of vitamin D are associated with multimorbidity: results from the LifeLines Cohort Study
.
Ann Med
.
2015
;
47
(
6
):
474
81
.
[PubMed]
0785-3890
15.
Li
YC
,
Qiao
G
,
Uskokovic
M
,
Xiang
W
,
Zheng
W
,
Kong
J
.
Vitamin D: a negative endocrine regulator of the renin-angiotensin system and blood pressure
.
J Steroid Biochem Mol Biol
.
2004
May
;
89-90
(
1-5
):
387
92
.
[PubMed]
0960-0760
16.
Mead
MN
.
Benefits of sunlight: a bright spot for human health
.
Environ Health Perspect
.
2008
Apr
;
116
(
4
):
A160
7
.
[PubMed]
0091-6765
17.
Feelisch
M
,
Kolb-Bachofen
V
,
Liu
D
,
Lundberg
JO
,
Revelo
LP
,
Suschek
CV
, et al.
Is sunlight good for our heart?
Eur Heart J
.
2010
May
;
31
(
9
):
1041
5
.
[PubMed]
0195-668X
18.
Razzaque
MS
.
Sunlight exposure: do health benefits outweigh harm?
J Steroid Biochem Mol Biol
.
2018
Jan
;
175
:
44
8
.
[PubMed]
0960-0760
19.
Colin-Ramirez
E
,
Ezekowitz
JA
;
SODIUM-HF investigators
.
Rationale and design of the Study of Dietary Intervention Under 100 MMOL in Heart Failure (SODIUM-HF)
.
Am Heart J
.
2018
Nov
;
205
:
87
96
.
[PubMed]
0002-8703
20.
Weather information: Korean Meteorological Administration;
2019
[Available from: http://www.weather.go.kr/weather/climate/past_table.jsp
21.
Terushkin
V
,
Bender
A
,
Psaty
EL
,
Engelsen
O
,
Wang
SQ
,
Halpern
AC
.
Estimated equivalency of vitamin D production from natural sun exposure versus oral vitamin D supplementation across seasons at two US latitudes
.
J Am Acad Dermatol
.
2010
Jun
;
62
(
6
):
929.e1
9
.
[PubMed]
0190-9622
22.
Palatini
P
,
Frigo
G
,
Bertolo
O
,
Roman
E
,
Winnicki
M
,
Winnicki
M
;
Da Cortà R
.
Validation of the A&D TM-2430 device for ambulatory blood pressure monitoring and evaluation of performance according to subjects’ characteristics
.
Blood Press Monit
.
1998
Aug
;
3
(
4
):
255
60
.
[PubMed]
1473-5725
23.
Parati
G
,
Stergiou
G
,
O’Brien
E
,
Asmar
R
,
Beilin
L
,
Bilo
G
, et al.;
European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability
.
European Society of Hypertension practice guidelines for ambulatory blood pressure monitoring
.
J Hypertens
.
2014
Jul
;
32
(
7
):
1359
66
.
[PubMed]
0263-6352
24.
Zhang
RH
,
He
DH
,
Zhou
B
,
Zhu
YB
,
Zhao
D
,
Huang
LC
, et al.
Analysis of vitamin D status in men highly exposed to sunlight
.
Biomed Environ Sci
.
2015
Dec
;
28
(
12
):
913
6
.
[PubMed]
0895-3988
25.
Hermida
RC
,
Ayala
DE
,
Mojón
A
,
Fernández
JR
.
Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level—the “normotensive non-dipper” paradox
.
Chronobiol Int
.
2013
Mar
;
30
(
1-2
):
87
98
.
[PubMed]
0742-0528
26.
Vaidya
A
,
Williams
JS
.
The relationship between vitamin D and the renin-angiotensin system in the pathophysiology of hypertension, kidney disease, and diabetes
.
Metabolism
.
2012
Apr
;
61
(
4
):
450
8
.
[PubMed]
0026-0495
27.
Li
YC
.
Vitamin D and the renin-angiotensin system. Vitamin D
.
Elsevier
;
2018
. pp.
825
47
.
28.
Li
YC
,
Kong
J
,
Wei
M
,
Chen
ZF
,
Liu
SQ
,
Cao
LP
.
1,25-Dihydroxyvitamin D(3) is a negative endocrine regulator of the renin-angiotensin system
.
J Clin Invest
.
2002
Jul
;
110
(
2
):
229
38
.
[PubMed]
0021-9738
29.
Meems
LM
,
van der Harst
P
,
van Gilst
WH
,
de Boer
RA
.
Vitamin D biology in heart failure: molecular mechanisms and systematic review
.
Curr Drug Targets
.
2011
Jan
;
12
(
1
):
29
41
.
[PubMed]
1389-4501
30.
de Boer
RA
,
Meems
LM
,
van Veldhuisen
DJ
.
Vitamin D supplementation in heart failure: case closed?
Eur Heart J
.
2017
Aug
;
38
(
29
):
2287
9
.
[PubMed]
0195-668X
31.
Brinkley
DM
,
Ali
OM
,
Zalawadiya
SK
,
Wang
TJ
.
Vitamin D and heart failure
.
Curr Heart Fail Rep
.
2017
Oct
;
14
(
5
):
410
20
.
[PubMed]
1546-9530
32.
Yuan
W
,
Pan
W
,
Kong
J
,
Zheng
W
,
Szeto
FL
,
Wong
KE
, et al.
1,25-dihydroxyvitamin D3 suppresses renin gene transcription by blocking the activity of the cyclic AMP response element in the renin gene promoter
.
J Biol Chem
.
2007
Oct
;
282
(
41
):
29821
30
.
[PubMed]
0021-9258
33.
Weng
S
,
Sprague
JE
,
Oh
J
,
Riek
AE
,
Chin
K
,
Garcia
M
, et al.
Vitamin D deficiency induces high blood pressure and accelerates atherosclerosis in mice
.
PLoS One
.
2013
;
8
(
1
):
e54625
.
[PubMed]
1932-6203
34.
Chen
S
,
Law
CS
,
Grigsby
CL
,
Olsen
K
,
Hong
TT
,
Zhang
Y
, et al.
Cardiomyocyte-specific deletion of the vitamin D receptor gene results in cardiac hypertrophy
.
Circulation
.
2011
Oct
;
124
(
17
):
1838
47
.
[PubMed]
0009-7322
35.
Pimenta
E
,
Gaddam
KK
,
Pratt-Ubunama
MN
,
Nishizaka
MK
,
Cofield
SS
,
Oparil
S
, et al.
Aldosterone excess and resistance to 24-h blood pressure control
.
J Hypertens
.
2007
Oct
;
25
(
10
):
2131
7
.
[PubMed]
0263-6352
36.
Laird
EJ
,
McNicholas
T
,
O'Halloran
AM
,
Healy
M
,
Molloy
AM
,
Carey
D
, et al.
Vitamin D Status Is Not Associated With Orthostatic Hypotension in Older Adults. Hypertension (Dallas, Tex : 1979).
2019
:Hypertensionaha11913064.
37.
Barbarawi
M
,
Kheiri
B
,
Zayed
Y
,
Barbarawi
O
,
Dhillon
H
,
Swaid
B
, et al.
Vitamin D Supplementation and Cardiovascular Disease Risks in More Than 83 000 Individuals in 21 Randomized Clinical Trials: A Meta-analysis
.
JAMA Cardiol
.
2019
Aug
;
4
(
8
):
765
76
.
[PubMed]
2380-6583
38.
Hanke
CJ
,
Drewett
JG
,
Myers
CR
,
Campbell
WB
.
Nitric oxide inhibits aldosterone synthesis by a guanylyl cyclase-independent effect
.
Endocrinology
.
1998
Oct
;
139
(
10
):
4053
60
.
[PubMed]
0013-7227
39.
Kreklau
EL
,
Carlson
EJ
,
Drewett
JG
.
Nitric oxide inhibits human aldosteronogenesis without guanylyl cyclase stimulation
.
Mol Cell Endocrinol
.
1999
Jul
;
153
(
1-2
):
103
11
.
[PubMed]
0303-7207
40.
Natarajan
R
,
Lanting
L
,
Bai
W
,
Bravo
EL
,
Nadler
J
.
The role of nitric oxide in the regulation of aldosterone synthesis by adrenal glomerulosa cells
.
J Steroid Biochem Mol Biol
.
1997
Apr
;
61
(
1-2
):
47
53
.
[PubMed]
0960-0760
41.
Holliman
G
,
Lowe
D
,
Cohen
H
,
Felton
S
,
Raj
K
.
Ultraviolet Radiation-Induced Production of Nitric Oxide:A multi-cell and multi-donor analysis
.
Sci Rep
.
2017
Sep
;
7
(
1
):
11105
.
[PubMed]
2045-2322
42.
Monaghan
C
,
McIlvenna
LC
,
Liddle
L
,
Burleigh
M
,
Weller
RB
,
Fernandez
BO
, et al.
The effects of two different doses of ultraviolet-A light exposure on nitric oxide metabolites and cardiorespiratory outcomes
.
Eur J Appl Physiol
.
2018
May
;
118
(
5
):
1043
52
.
[PubMed]
1439-6319
43.
Pascoe
MC
,
Thompson
DR
,
Jenkins
ZM
,
Ski
CF
.
Mindfulness mediates the physiological markers of stress: systematic review and meta-analysis
.
J Psychiatr Res
.
2017
Dec
;
95
:
156
78
.
[PubMed]
0022-3956
44.
Barnes
JN
.
Sex-specific factors regulating pressure and flow
.
Exp Physiol
.
2017
Nov
;
102
(
11
):
1385
92
.
[PubMed]
0958-0670
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