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Background  Observational studies have reported an inverse association between ultraviolet (UV) radiation and hypertension. The aim of this study was to assess differences in blood pressure changes between persons with dementia receiving UV light versus vitamin D (VD) supplementation.    Methods  Post-hoc analysis of randomized controlled trial data concerning nursing home residents with dementia ( N  = 61; 41 women, mean age 84.8 years). The participants received half-body UV irradiation, twice weekly over 6 months, at one standard erythema dose (UV group,  n  = 22) or 5600 international units of cholecalciferol once a week (VD group,  n  = 39). Short-term effects were evaluated after 1 month and long-term effects after 3 and 6 months. Differences in blood pressure changes were assessed using linear mixed models.    Results  With the VD group as a reference, the estimated difference in mean change of systolic blood pressure was − 26.0 mmHg [95% confidence interval (CI) -39.9, − 12.1,  p  = .000] at 1 month, 4.5 mmHg (95% CI -6.8, 15.9,  p  = 0.432) at 3 months, and 0.1 (95% CI -14.1, 14.3,  p  = 0.83) at 6 months. The estimated difference in diastolic blood pressure was − 10.0 mmHg (95% CI -19.2, − 0.7,  p  = 0.035) at 1 month, 3.6 mmHg (95% CI -4.1, 11.2,  p  = 0.358) at 3 months, and 2.7 (95% CI -6.8, 12.1,  p  = 0.580) at 6 months.    Conclusions  UV light had only a short-term effect but not a long-term effect on blood pressure reduction compared to VD use in this sample of normotensive to mild hypertensive nursing home residents with dementia. Future studies will be needed to determine the effect of UV light in different samples of the population and especially in a population with hypertension.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12877-021-02538-7.

The effect of ultraviolet irradiation compared to oral vitamin D supplementation on blood pressure of nursing home residents with dementia