Hypertension

HTN: Calcium (2015)

• Intervention
  What is the relationship between calcium intake from food sources and blood pressure in adults with hypertension?

  • Conclusion
    In four of six studies of adults with hypertension, total dietary calcium intake of 800mg or more per day (primarily from dairy products) reduced systolic blood pressure up to 4.0mmHg and diastolic blood pressure up to 2.0mmHg.
  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the relationship between calcium intake from food sources and blood pressure in adults with hypertension?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Hilpert KF, West SG, Bagshaw DM, Fishell V, Barnhart L, Lefevre M, Most MM, Zemel MB, Chow M, Hinderliter AL, Kris-Etherton PM. Effects of dairy products on intracellular calcium and blood pressure in adults with essential hypertension. J Am Coll Nutr. 2009; 28(2): 142-149.
      • Lancaster KJ, Smiciklas-Wright H, Weltzel LB, Mitchell DC, Friedman JM, Jensen GL. Hypertension-related dietary patterns of rural older adults. Preventive Medicine, 2004; 38: 812-818.
      • Toledo E, Delgado-Rodriguez M, Estruch R, Salas-Salvado J, Corella D, Gomez-Gracia E, Fiol M, Lamuela-Raventos RM, Schroder H, Aros F, Ros E, Ruiz-Gutierrez V, Lapetra J, Conde-Herrera M, Saez G, Vinyoles E, Martinez-Gonzalez MA. Low-fat dairy products and blood pressure: Follow-up of 2,290 older persons at high cardiovascular risk participating in the PREDIMED study. Br J Nutr. 2009; 101: 59-67.
      • van Mierlo LAJ, Arends LR, Streppel MT, Kok FJ, Grobbee DE. Blood pressure response to calcium supplementation: A meta-analysis of randomized controlled trials. J Hum Hypertens. 2006; 20: 571-580.
      • Varenna M, Manara M, Galli L, Binelli L, Zucchi M, Sinigaglia L. The association betweeen osteoporosis and hypertension: The role of a low dairy intake. Calcif Tissue Int. 2013; 93: 86-92.
  • Search Plan and Results: HTN: Minerals (Calcium) 2014
     
  What is the relationship between calcium intake from supplements and blood pressure in adults with hypertension?

  • Conclusion
    In two meta-analyses of adults with hypertension, calcium supplementation of 1,000mg to 1,500mg per day reduced systolic blood pressure up to 3.0mmHg and diastolic blood pressure up to 2.5mmHg. One RCT did not find significant effects on blood pressure with calcium supplementation.
  • Grade: I
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the relationship between calcium intake from supplements and blood pressure in adults with hypertension?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Dickinson HO, Nicolson D, Cook JV, Campbell F, Beyer FR, Ford GA, Mason J. Calcium supplementation for the management of primary hypertension in adults. Cochrane Database Syst Rev. 2006; 2: CD004639.
      • Pikilidou, MI, Befani CD, Sarafidis PA, Nilsson PM, Koliakos GG, Tziolas IM, Kazakos KA, Yovos JG, Lasaridis AN. Oral calcium supplementation ambulatory blood pressure and relation to changes in intracellular ions and sodium-hydrogen exchange. Am J Hypertens. 2009; 22: 1,263-1,269.
      • van Mierlo LAJ, Arends LR, Streppel MT, Kok FJ, Grobbee DE. Blood pressure response to calcium supplementation: A meta-analysis of randomized controlled trials. J Hum Hypertens. 2006; 20: 571-580.
  • Search Plan and Results: HTN: Minerals (Calcium) 2014