Retrospective Evaluation of the Association Between Vitamin D Status and Blood Pressure Among Saudi Adolescents: A Five-Year Cohort Study

Background: Vitamin D deficiency is prevalent among adolescents and may contribute to cardiometabolic risk factors, including elevated blood pressure. Limited evidence exists regarding this association in Saudi adolescents. Objective: To evaluate the association between vitamin D status and blood pressure in a retrospective cohort of Saudi adolescents. Methods: We reviewed electronic health records of 1,960 adolescents (12–18 years) attending King Faisal University-affiliated medical centers from January 2019–September 2024. Serum 25(OH)D levels, anthropometrics, blood pressure readings, and metabolic parameters were extracted. Adolescents were categorized as vitamin D deficient (<30 nmol/L), insufficient (30–49 nmol/L), or sufficient (≥50 nmol/L). Multivariable linear and logistic regression analyses examined the relationship between vitamin D categories and blood pressure status, adjusting for age, sex, BMI, and metabolic factors. Results: Vitamin D deficiency was observed in 42.4% of participants. Deficient adolescents had higher mean systolic and diastolic blood pressure and a greater prevalence of prehypertension/hypertension (27.1%) compared to sufficient peers (15.2%; p<0.001). Adjusted analyses revealed that vitamin D deficiency was associated with increased odds of elevated blood pressure (OR=1.58, 95% CI: 1.29–1.93, p<0.001). Sensitivity analyses stratified by BMI and sex produced consistent findings. Conclusions: Vitamin D deficiency was independently associated with elevated blood pressure in Saudi adolescents. Addressing vitamin D deficiency may serve as an early preventive measure against the development of hypertension and its sequelae. Further prospective and interventional studies are warranted to guide clinical practice.