Quick Links

Recommendations Summary

HTN: Calcium 2008

Click here to see the explanation of recommendation ratings (Strong, Fair, Weak, Consensus, Insufficient Evidence) and labels (Imperative or Conditional). To see more detail on the evidence from which the following recommendations were drawn, use the hyperlinks in the Supporting Evidence Section below.

  • Recommendation(s)


    If calcium is proposed as a therapy to reduce blood pressure, advise that the effect of calcium as a single nutrient on blood pressure in healthy or hypertensive adults is unclear. Epidemiological studies report that dietary patterns containing calcium lower than recommended levels (DRI) may be associated with elevated blood pressure. The effect of dietary patterns with calcium intake above the DRI on blood pressure in healthy or hypertensive adults is minimal.

    Rating: Fair

    • Risks/Harms of Implementing This Recommendation


    • Conditions of Application

      This recommendation applies to individuals asking about calcium as a therapy to reduce blood pressure.

    • Potential Costs Associated with Application


    • Recommendation Narrative

      • Seven cross-sectional studies with calcium intakes below recommended levels  report an association with increased blood pressure, however, it is unclear if this is confounded by other dietary factors (Jorde and Bonaa, 2000; Morikawa et al, 2002; Schroder et al, 2002; Hajjar and Kotchen, 2003; Hajjar et al, 2003; Kwok et al, 2003; Zhao et al, 2004).
      • However, one cohort study did not report significant differences between hypertensive and normotensive subjects, although both groups reported low calcium intakes (Lancaster et al, 2004).
      • One cross-sectional study with calcium intakes near recommended levels reported no statistically significant differences in blood pressure between hypertensive patients and controls (Silaste et al, 2000).
      • One meta-analysis of calcium intakes above recommended levels showed a minimal decrease in blood pressure (Geleijnse et al, 2004).

    • Recommendation Strength Rationale

      • Conclusion Statement is a Grade II.

    • Minority Opinions

      Consensus reached.