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Calcium supplementation for the management of primary hypertension in adults

University of Newcastle, National Guideline Research & Development Unit, 21 Claremont Place, Newcastle upon Tyne, Tyne & Wear, UK, NE2 4AA.
Cochrane database of systematic reviews (Online) (Impact Factor: 5.94). 02/2006; 2(2):CD004639. DOI: 10.1002/14651858.CD004639.pub2
Source: PubMed

ABSTRACT This review did not find robust evidence that oral calcium supplementation reduces high blood pressure in adults. It reviewed 13 trials enrolling 485 people, which compared calcium supplementation with placebo or no treatment, and measured blood pressure 8 to 15 weeks later. On average, people receiving extra calcium achieved slightly lower systolic blood pressure at the end of trials. However, most trials were of poor quality, so their results may not be reliable. Trials were too small and short to measure whether extra calcium reduces the risk of death, heart attack or stroke. Calcium usually had no more adverse effects than placebo. Larger, longer duration, better quality trials are needed to clarify whether calcium supplementation can lower high blood pressure.

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    • "So, it is difficult to conclude that Ca intakes per se in the range of 1,000–1,200 mg/day can be associated with cardiovascular events (60). There are also opposing findings with no increase in cardiovascular events (40, 41), and supplements may even improve some vascular risk factors, e.g., blood pressure (37, 45). "
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    ABSTRACT: Calcium (Ca) is an essential nutrient for the human body. Despite lively research, there is uncertainty about Ca requirements in terms of desirable health outcomes including an upper intake level above which the potential for harm increases. The aim was to conduct a review to update requirements and desirable or harmful health effects of Ca on the current scientific evidence. We searched Medline and Swemed from January 2000 to December 2011 and included all systematic reviews that reported Ca supplementation or usual Ca intake on health outcomes. Meta-analyses, randomized clinical trials and cohort studies were included in the second search between May 2009 and March 2011 and an additional search covering studies till the end of 2011. This review concentrated on studies reporting independent effects of Ca, although a few recent trials report sole effects of Ca on health outcomes, most trials use Ca in combination with vitamin D vs. placebo. In total, we reviewed 38 studies addressing the effects of Ca on bone, pregnancy-related outcomes, cancers, cardiovascular outcomes, obesity, and mortality. There was a lot of heterogeneity in the study protocols, which made it difficult to draw any strong conclusions. According to the literature, high Ca intake seems to have a small positive effect on bone mineral content (BMC) or bone mineral density (BMD) in children and postmenopausal women. We did not find any consistent evidence on the effects of Ca on bone health in premenopausal women or men. Also, the evidence that Ca supplementation reduces fracture incidence is scarce and inconsistent. Maternal diet may influence the peak bone mass of offspring but more studies are required. There was no overall effect of Ca intake on cancers. Ca was associated with a decreased risk of breast cancer and a slightly increased risk of prostate cancer in two of the three studies. No associations were found with other cancers. We found no consistent association between cardiovascular outcomes and Ca intake except for blood pressure. A small decrease of 2-4 mmHg in systolic blood pressure was found in pregnant and in hypertensive subjects with Ca supplementation. Reviewed studies did not show consistent evidence relating Ca intake to either mortality or obesity. Based on this evidence, there is no need to change the Nordic recommendations for Ca intake. However, due to heterogeneity in the studies it is difficult to interpret the results and provide single summary statement.
    Food & Nutrition Research 05/2013; 57. DOI:10.3402/fnr.v57i0.21082 · 1.79 Impact Factor
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    • "Several epidemiological studies have reported that people who have a higher intake of calcium tend to have lower blood pressure. Dickinson et al. [26] conducted a meta-analysis and demonstrated that calcium supplementation is effective in lowering blood pressure and hypertension risk. They analyzed 13 randomized controlled trials and found that participants receiving calcium supplementation, when compared to controls, had a statistically significant reduction in SBP (mean difference: -2.5 mmHg, 95% CI: -4.5 mmHg to -0.6 mmHg) but not in DBP (mean difference: -0.8 mmHg, 95% CI: -2.1 mmHg to 0.4 mmHg). "
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    ABSTRACT: Regional differences between large cities and rural areas are observed in the Korean National Health and Nutrition Examination Survey (KNHANES). This present study was conducted to evaluate the effect of dietary factors on hypertension risk in Korean populations, especially residents of the Chungcheong province which was not in metropolitan area, using KNHANES III. A total of 544 adults aged ≥ 19 years were placed into either the normotensive or the hypertensive group. Subject characteristics, BMI, blood pressure, and nutrient intakes were compared between the two groups using a chi-square test and t-test. We estimated odds ratios (ORs) using multiple logistic regression, adjusted for energy intake and selected covariates. There were significant differences in age, education level, alcohol consumption, and BMI between the normotensive and hypertensive groups. We found decreased ORs for the medium versus lowest tertile of calcium intake (multivariate OR = 0.43, 95% CI: 0.21-0.88), for the highest versus lowest tertile of calcium intake (multivariate OR = 0.43, 95% CI: 0.20-0.90) with significant trends in risk (P = 0.040), and for the medium versus lowest tertile of potassium intake (multivariate OR = 0.43, 95% CI: 0.20-0.89). Subjects with the highest sodium/calcium ratio had a 2.10-fold greater risk of hypertension compared to the subject with the lowest, with significant trends in risk (P = 0.002). Adequate calcium and potassium intake should be encouraged and regional differences should be considered in making a healthy plan for hypertension management.
    Nutrition research and practice 02/2011; 5(1):60-5. DOI:10.4162/nrp.2011.5.1.60 · 1.13 Impact Factor
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    • "Dickinson et al. [30] conducted a meta-analysis and demonstrated that calcium supplementation is effective in lowering blood pressure and hypertension risk. They analyzed 13 randomized controlled trials and found that participants receiving calcium supplementation, when compared to controls, had a statistically significant reduction in SBP (mean difference: -2.5 mmHg, 95% CI: -4.5 mmHg to -0.6 mmHg) but not in DBP (mean difference: -0.8 mmHg, 95% CI: -2.1 mmHg to 0.4 mmHg) [30]. Another meta-analysis also combined 40 clinical trials and revealed that calcium supplementation (mean daily dose: 1,200 mg) reduced SBP by -1.86 mm Hg (95% CI: -2.91 mmHg to -0.81 mmHg) and DBP by -0.99 mm Hg (95% CI: -1.61 mmHg to -0.37 mmHg) [31]. "
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    ABSTRACT: Epidemiological evidence of the effects of dietary sodium, calcium, and potassium, and anthropometric indexes on blood pressure is still inconsistent. To investigate the relationship between dietary factors or anthropometric indexes and hypertension risk, we examined the association of systolic and diastolic blood pressure (SBP and DBP) with sodium, calcium, and potassium intakes and anthropometric indexes in 19~49-year-olds using data from Korean National Health and Nutrition Examination Survey (KNHANES) III. Total of 2,761 young and middle aged adults (574 aged 19~29 years and 2,187 aged 30~49 years) were selected from KNHANES III. General information, nutritional status, and anthropometric data were compared between two age groups (19~29 years old and 30~49 years old). The relevance of blood pressure and risk factors such as age, sex, body mass index (BMI), weight, waist circumference, and the intakes of sodium, potassium, and calcium was determined by multiple regression analysis. Multiple regression models showed that waist circumference, weight, and BMI were positively associated with SBP and DBP in both age groups. Sodium and potassium intakes were not associated with either SBP or DBP. Among 30~49-year-olds, calcium was inversely associated with both SBP and DBP (P = 0.012 and 0.010, respectively). Our findings suggest that encouraging calcium consumption and weight control may play an important role in the primary prevention and management of hypertension in early adulthood.
    Nutrition research and practice 04/2010; 4(2):155-62. DOI:10.4162/nrp.2010.4.2.155 · 1.13 Impact Factor
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