Advertisement

Calcium Metabolism and Arterial Pressure Regulation in Humans

  • D. A. McCarron
  • E. W. Young
  • R. D. Bukoski
  • C. D. Morris
Conference paper

Abstract

This chapter summarizes the current status of several aspects of the relationship between calcium metabolism and blood pressure control. These include epidemiological evidence linking dietary calcium intake to blood pressure status and the results of clinical intervention trials intended to lower blood pressure by increasing calcium intake in humans. In addition, the potential mechanisms by which dietary calcium lowers blood pressure will be considered. We conclude with speculation as to clinical situations associated with an increased risk of hypertensive heart disease in which calcium metabolism may emerge as an important pathophysiologic and/or therapeutic consideration.

Keywords

Calcium Intake Calcium Supplementation Dietary Calcium Blood Pressure Response Calcium Metabolism 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Ackley S, Barrett-Connor E, Suarez L (1983) Dairy products, calcium and blood pressure. Am J Clin Nutr 38:457–461PubMedGoogle Scholar
  2. Ambrecht HJ, Forte LR, Halloran BP (1984) Effect of age and dietary calcium on renal 25(0H)D metabolism, serum l,25(OH)2D and PTH. Am J Physiol 246:E266-E270Google Scholar
  3. Belizan JM, Villar J, Pineda O, Gonzalez AE, Sainz E, Garrera G, Sibrian R (1983) Reduction of blood pressure with calcium supplementation in young adults. JAMA 249:1161–1165PubMedCrossRefGoogle Scholar
  4. Bernstein J, Santacona G (1987) Effects of ethanol on calcium transport across the liver cell plasma membrane. Res Commun Chem Pathol Pharmacol 56:49–74PubMedGoogle Scholar
  5. Berthelot A, Gairard A (1980) Parathyroid hormone- and deoxycorticosterone acetate-induced hypertension in the rat. Clin Sci 58:365–371PubMedGoogle Scholar
  6. Bierenbaum ML, Wolf E, Raff M, Maginnis WP (1987) The effect of dietary calcium supplementation on blood pressure and serum lipid levels: preliminary report. Nutr Rep Int 36:1147–1157Google Scholar
  7. Bindels RJM, Van Den Broek LAM, Hillebrand SJW, Wokke JMP (1987) A high phosphate diet lowers blood pressure in spontaneously hypertensive rats. Hypertension 9:96–102PubMedGoogle Scholar
  8. Bloomfield RL, Young LD, Zurek G, Felts JH, Straw MK (1986) Effect of oral calcium carbonate on blood pressure in subjects with mildly elevated arterial pressure. J Hypertens 4[Suppl 5]: S351-S354Google Scholar
  9. Bohr DF (1963) Vascular smooth muscle: dual effect of calcium. Science 139:597–599PubMedCrossRefGoogle Scholar
  10. Bukoski RD, McCarron DA (1986) Altered aortic reactivity and lowered blood pressure associated with high Ca2+ intake in the SHR. Am J Physiol 251(20):H976-H983PubMedGoogle Scholar
  11. Bukoski RD, Xue H, McCarron DA (1987) Effect of 1,25 (OH)2 vitamin D3 and ionized Ca2+ on 45Ca uptake by primary cultures of aortic myocytes of spontaneously hypertensive and Wistar Kyoto normotensive rats. Biochem Biophys Res Commun 146(3): 1330–1335PubMedCrossRefGoogle Scholar
  12. Bukoski RD, Xue H, DeWan P, McCarron DA (1988) Calciotropic hormones and vascular calcium metabolism in experimental hypertension. In: Halpern W, et al. (eds) Proceedings of the second international symposium on resistance arteries. Perinatology Press, Ithaca pp 320–328Google Scholar
  13. Caggiula AW, Milas NC, McKenzie JM, Sugars C (1986) Nutrition intake and blood pressure in the multiple risk factor intervention trial (abstract). CVD Epidemiol News 41:27Google Scholar
  14. Cappuccio FP, Markandu ND, Singer DRJ, Smith SJ, Shore AC, MacGregor GA (1987) Does oral calcium supplementation lower high blood pressure? A double blind study. J Hypertens 5:67–71PubMedCrossRefGoogle Scholar
  15. Collip JB (1925) The extraction of a parathyroid hormone which will prevent or control parathyroid tetany and which regulates the level of blood calcium. J Biol Chem 63:395–401Google Scholar
  16. De Marchi S, Cecchin E, Basile A (1984) Fractures and hypercalciuria: two markers of severe dependence in alcoholics. Br Med J 288:1457–1458CrossRefGoogle Scholar
  17. Folsom AR, Smith CL, Prineas RJ, Grim RH (1986) Serum calcium fractions in essential hypertension and matched normotensive subjects. Hypertension 8:11–15PubMedGoogle Scholar
  18. Gaboury C, Karanja N, McCarron DA (1988) Glucose intolerance and spontaneous hypertension (abstract). Kidney Int 33:296Google Scholar
  19. Gallagher JC, Riggs BL, Eisman J, Hamstra A, Arnaud SB, DeLuca HF (1979) Intestinal calcium absorption and serum vitamin D metabolites in normal subjects and osteoporotic patients. Effects of age and dietary calcium. J Clin Invest 66:729–736CrossRefGoogle Scholar
  20. Garcia-Palmieri MR, Costas R Jr, Cruz-Vidal M, Sorlie PD, Tillotson J, Havlik RJ (1984) Milk consumption, calcium intake and decreased hypertension in Puerto Rico: Puerto Rico heart health program study. Hypertension 6:322–328PubMedGoogle Scholar
  21. Gilliland M, Zawada ET, McClung D, TerWee J (1987) Preliminary report: nutriuretic effect of calcium supplementation in hypertensive women over forty. J Am Coll Nutr 6:139–143PubMedGoogle Scholar
  22. Grobbee DE, Hofman A (1986) Calcium supplementation lowers blood pressure in young mildly hypertensive subjects: a randomized, controlled trial. Lancet 11:703–707CrossRefGoogle Scholar
  23. Gruchow HW, Sobocinski KA, Barboriak JJ (1985) Alcohol, nutrient intake and hypertension in US adults. JAMA 253:1567–1570PubMedCrossRefGoogle Scholar
  24. Gruchow HW, Sobocinski KA, Barboriak JJ (1986) Threshold effects of dietary calcium on blood pressure. J Hypertens 4[Suppl 5]:S355-S357Google Scholar
  25. Hamet P, Skuherska R, Cherkaoui L, Pang SC, Amer V, Tremblay J (1986) Calcium levels and platelet responsiveness in spontaneously hypertensive rats on high calcium diet. J Hypertens 4[Suppl 6]:S-716Google Scholar
  26. Harlan WR, Hull AL, Schmouder RL, Landis JL, Thompson FE, Larkin FA (1984) Blood pressure and nutrition in adults. Am J Epidemiol 120:17–28PubMedGoogle Scholar
  27. Harlan WR, Hull AL, Schmouder RL, Landis JL, Larking FA, Thompson FE (1985a) High blood pressure in older Americans: the first national health and nutrition examination survey. Hypertension 6:802–809Google Scholar
  28. Harlan WR, Landis JR, Schmouder RL (1985b) Blood lead and blood pressure: relationship in adolescent and adult U.S. population. JAMA 253:530–534PubMedCrossRefGoogle Scholar
  29. Hatton DC, Huie PE, Muntzel MS, Metz JA, McCarron DA (1987a) Stress-induced hypertension in the SHR: effect of dietary calcium. Am J Physiol 252(21):48–54Google Scholar
  30. Hatton D, Muntzel M, McCarron D, Scrogin K, Pressley M, Bukoski R (1987b) Early influence of dietary calcium on blood pressure (BP) and plasma volume (abstract). Fed Proc 46:1071Google Scholar
  31. Hatton D, Muntzel M, Absalon J, McCarron D (1988) Dietary Ca and Fe interaction on hematocrit in the SHR (abstract). FASEB J 2:A969Google Scholar
  32. Heath H, Lambert PW, Service FJ, Arnaud SB (1979) Calcium homeostasis in diabetes mellitus. J Clin Endocrinol Metab 49:462–466PubMedCrossRefGoogle Scholar
  33. Hirata Y, Takata S, Takagi Y, Tashimi H, Fujita T (1987) Parathyroid hormone receptors in vascular smooth muscle and endothelial cells. Proceedings of the first international conference on parathyroid hormone, KobeGoogle Scholar
  34. Huie PE, Hatton DC, Muntzel MS, Metz J, McCarron DA (1987) Psychosocial stress, dietary calcium and hypertension in the SHR. Physiol Behav 40:425–429PubMedCrossRefGoogle Scholar
  35. Ireland P, Fordtran JS (1973) Effect of dietary calcium and age on jejunal calcium absorption in humans studied by intestinal perfusion. J Clin Invest 52:2672–2681PubMedCrossRefGoogle Scholar
  36. Joffres MR, Reed DM, Yano K (1987) Relationship of magnesium intake and dietary factors to blood pressure: the Honolulu heart study. Am J Clin Nutr 45:469–475PubMedGoogle Scholar
  37. Johnson NE, Smith EL, Freudenheim J (1985) Effects on blood pressure of calcium supplementation of woman. Am J Clin Nutr 42:12–17PubMedGoogle Scholar
  38. Kaplan NM, Meese RB (1986) The calcium deficiency hypothesis of hypertension: a critique. Ann Intern Med 105:947–955PubMedGoogle Scholar
  39. Kawasaki N, Matsui K, Ito M, Nakamura T, Yoshimura T, Ushijima H, Maeyama M (1985) Effect of calcium supplementation on the vascular sensitivity to angiotensin II in pregnant women. Am J Obstet Gynecol 153:576–582PubMedGoogle Scholar
  40. Kawashima H (1987) Receptor for 1,25-dihydroxyvitamin D in a vascular smooth muscle cell line derived from rat aorta. Biochem Biophys Res Commun 146:1–6PubMedCrossRefGoogle Scholar
  41. Kok FJ, Vandenbrouke JP, Vander-Heide-Wessel C, Vander-Heide R (1986) Dietary sodium, calcium and potassium and blood pressure. Am J Epidemiol 123:1043–1048PubMedGoogle Scholar
  42. Kromhout D, Bosschieter EB, Coulander G (1985) Potassium, calcium, alcohol intake and blood pressure: the Zutphen study. Am J Clin Nutr 41:1299–1304PubMedGoogle Scholar
  43. Kurtz TW, Al-Bander HA, Morris RC Jr (1987) “Salt-sensitive” essential hypertension in men. N Engl J Med 317:1043–1048PubMedCrossRefGoogle Scholar
  44. Lacour B, Roullet CM, Lucas PA, McCarron DA, Drüeke T (1988) Impaired calcium efflux in enterocytes of spontaneously hypertensive rat (SHR). Kidney Int 33:300Google Scholar
  45. Lau K, Chen S, Eby B (1984) Evidence for the role of P04 deficiency in antihypertensive action of a high-Ca diet. Am J Physiol 246:H324-H331PubMedGoogle Scholar
  46. Levin ME, Boisseau VC, Avioli LV (1976) Effect of diabetes mellitus on bone mass in juvenile and adult onset diabetes. N Engl J Med 294:241–245PubMedCrossRefGoogle Scholar
  47. Liebman M, Chopin LF, Carter E, Clark AJ, Disney GW, Hegsted M, Kenney MA, Kirmani ZA, Koonce KL, Korslund MK, Moak SW, McCoy H, Stallings SF, Wakefield T (1986) Factors related to blood pressure in a biracial adolescent female population. Hypertension 8:843–850PubMedGoogle Scholar
  48. Luft FC, Aronoff GR, Sloan RS, Fineberg NS, Weinberger MH (1986) Short-term augmented calcium intake has no effect on sodium homeostasis. Clin Pharmacol Ther 39:414–419PubMedCrossRefGoogle Scholar
  49. Lyle RM, Melby CL, Hyner GC, Edmondson JW, Miller JZ, Weinberger MH (1987) Blood pressure and metabolic effects of calcium supplementation in normotensive white and black men. JAMA 257:1772–1776PubMedCrossRefGoogle Scholar
  50. MacGregor GA, Markandu ND, Sagnella GA (1982) Dietary sodium restriction in normotensive subjects and patients with essential hypertension. Clin Sci 63:399–402Google Scholar
  51. Marya RK, Rathee S, Manrow M (1987) Effect of calcium and vitamin D supplementation on toxaemia of pregnancy. Gynecol Obstet Invest 24:38–42PubMedCrossRefGoogle Scholar
  52. McCarron DA, Morris CD (1985) Blood pressure response to oral calcium in persons with mild to moderate hypertension: a randomized, double-blind, placebo-controlled, crossover trial. Ann Intern Med 103:825–831PubMedGoogle Scholar
  53. McCarron DA, Morris CD, Cole C (1982) Dietary calcium vs. human hypertension. Science 217:267–269PubMedCrossRefGoogle Scholar
  54. McCarron DA, Morris CD, Henry HJ, Stanton JL (1984a) Blood pressure and nutrient intake in the United States. Science 224:1392–1398PubMedCrossRefGoogle Scholar
  55. McCarron DA, Ellison DH, Anderson S (1984b) Vasodilation mediated by human PTH 1–34 in the spontaneously hypertensive rat. Am J Physiol 246:F96-F100PubMedGoogle Scholar
  56. McCarron DA, Lucas PA, Shneidman RS, Drüeke T (1985) Blood pressure development of the spontaneously hypertensive rat following concurrent manipulation of the dietary Ca2+ and Na+: relation to intestinal Ca2+ fluxes. J Clin Invest 76:1147–1154PubMedCrossRefGoogle Scholar
  57. McGarvey ST, Zinner SH, Rosner B, Willett WC, OhW (1988) Maternal prenatal dietary calcium and magnesium intake and infant blood pressure (abstract). CVD Epidemiol News 43:18Google Scholar
  58. Meese RB, Gonzales DG, Casparian JM, Dam CVS, Pak CYC, Kaplan NM (1986) Failure of calcium supplements to relieve hypertension. Clin Res 34:A218Google Scholar
  59. Mondon CE, Reaven GM (1988) Evidence of abnormalities of insulin metabolism in rats with spontaneous hypertension. Metabolism 37:303–305PubMedCrossRefGoogle Scholar
  60. Morris CD, McCarron DA (1985) Calcium supplementation in hypertension: effect after 8 and 16 weeks of treatment (abstract). Proceedings of the second European meeting on hypertension.Google Scholar
  61. Morris CD, McCarron DA (1987) Dietary calcium intake in hypertension. Hypertension 10:350–352PubMedGoogle Scholar
  62. Morris CD, McCarron DA (1988) Age has different effects by sex on blood pressure response to calcium supplementation (abstract). Am J Hypertens 1:26AGoogle Scholar
  63. Morris CD, Karanja N, McCarron DA (1988a) Dietary vs. supplemental calcium to reduce blood pressure (abstract). Clin Res 36:A139Google Scholar
  64. Morris CD, Karanja N, McCarron DA (1988b) Blood pressure reduction with calcium supplementation: comparison of dietary calcium vs CaC03 (abstract). Am J Hypertens (in press)Google Scholar
  65. Nichaman M, Shekelle R, Paul O (1984) Diet, alcohol, and blood pressure in the Western electric study. Am J Epidemiol 120:469–470Google Scholar
  66. Pang PKT, Tenner TE Jr, Yee JA, Yang M, Janssen HF (1980) Hypotensive action of parathyroid hormone preparations on rats and dogs. Proc Natl Acad Sci USA 77:675–678PubMedCrossRefGoogle Scholar
  67. Pederson EB, Johannesen P, Kristensen S, Rasmussen AB, Emmertsen K (1984) Calcium, parathyroid hormone and calcitonin in normal pregnancy and preeclampsia. Gynecol Obstet Invest 18:156–164CrossRefGoogle Scholar
  68. Pershadsingh HA, Kurtz TW (1988) Insulin resistance in hypertension (letter). N Engl J Med 318:383–384CrossRefGoogle Scholar
  69. Peuler JD, Morgan DA, Mark AL (1987) High calcium diet reduces blood pressure in Dahl salt-sensitive rats by neural mechanisms. Hypertension 9[Suppl III]: 159–165Google Scholar
  70. Reed D, McGee D, Yamo K, Hankin J (1985) Diet, blood pressure and multicollinearity. Hypertension 7:405–411PubMedGoogle Scholar
  71. Resnick LM (1985) Calcium and hypertension: the emerging connection (editorial). Ann Intern Med 103:944–946PubMedGoogle Scholar
  72. Resnick LM, Laragh JH (1983) The hypotensive effect of short-term oral calcium loading in essential hypertension (abstract). Clin Res 31:334Google Scholar
  73. Resnick LM, Laragh JH, Sealey JE, Alderman MH (1983) Divalent cations in essential hypertension: relations between serum ionized calcium, magnesium and plasma renin activity. N Engl J Med 309:888–891PubMedCrossRefGoogle Scholar
  74. Richards AM, Espiner EA, Maslowski AH, Nicholls MG, Ikram H, Hamilton EJ, Wells JE (1984) Blood pressure response to moderate sodium restriction and to potassium supplementation in mild essential hypertension. Lancet 1:757–761PubMedCrossRefGoogle Scholar
  75. Rose G (1981) Strategy of prevention: lessons from cardiovascular disease. Br Med J [Clin Res] 282:1847–1851CrossRefGoogle Scholar
  76. Ross D (1986) Chronic ethanol administration inhibits calmodulin-dependent Ca2+ uptake in synaptosomal membranes. Pharmacol Biochem Behav 24:1659:1664Google Scholar
  77. Schaerstrom R, Hamfelt A, Soderjelm L (1986) Parathyroid hormone and calcitonin in diabetes mellitus. Up J Med Sci 91:99–104CrossRefGoogle Scholar
  78. Scrogin KE, Hatton DC, Metz JA, Muntzel MS, McCarron DA (1987) Effect of dietary calcium on stress-induced catecholamine release and sensitivity in the spontaneously hypertensive rat. Proceedings of the society of neuroscience annual meetingGoogle Scholar
  79. Sempos CT, Cooper RS, Johnson C, Drizd TA, Yetley EA (1985) Association of dietary and serum calcium to blood pressure in adults 40–74 years. Am J Epidemiol 122:548Google Scholar
  80. Sempos C, Cooper R, Kovar MG, Johnson C, Drizd T, Yetley E (1986) Dietary calcium and blood pressure in national health and nutrition examination surveys I and II. Hypertension 8:1067–1074PubMedGoogle Scholar
  81. Shuler C, Karanja N, Dolney AM, McCarron DA (1988) Dietary calcium supplementation enhances aortic synthesis of PGI2 and decreases platelet thromboxane generation in spontaneously hypertensive rats (abstract). Clin Res 36:A432Google Scholar
  82. Stern N, Lee DBN, Silis V, Beck FWJ, Deftos L, Manalagas SC, Sowers JR (1984) Effects of high calcium intake on blood pressure and calcium metabolism in young SHR. Hypertension 6:639–646PubMedGoogle Scholar
  83. Strazzullo P, Siani A, Gugliemi S, DiCarlo A, Galletti F, Cirillo M, Mancini M (1986) Controlled trial of long-term oral calcium supplementation in essential hypertension. Hypertension 8:1084–1088PubMedGoogle Scholar
  84. Svetkey LP, Yarger WE, Feussner JR, DeLong E, Klotman PE (1987) Double-blind, placebo-controlled trial of potassium chloride in the treatment of mild hypertension. Hypertension 9:444–450PubMedGoogle Scholar
  85. Tabuchi Y, Ogihara T, Hashizume H, Saito H, Kumahara Y (1986) Hypotensive effect of long-term oral calcium supplementation in elderly patients with essential hypertension. J Clin Hypertens 3:254–262Google Scholar
  86. Taufield PA, Ales KL, Resnick LM, Druzin ML, Gertner JM, Laragh JH (1987) Hypocalciuria in preeclampsia. N Engl J Med 316:715–718PubMedCrossRefGoogle Scholar
  87. Thomsen K, Nilas L, Christiansen C (1987) Dietary calcium intake and blood pressure in normotensive subjects. Acta Med Scand 222:51–56PubMedCrossRefGoogle Scholar
  88. Trevisan M, Krough V, Farinaro E, Panico S, Mancini M (1986) Relationship between total and varied sources of dietary calcium intake and blood pressure (abstract). Am J Epidemiol 124:507Google Scholar
  89. Umemura S, Smyth DD, Nicar M, Rapp JP, Pettinger WA (1986) Altered calcium homeostasis in Dahl hypertensive rats: physiological and biochemical studies. J Hypertens 4:19–26PubMedCrossRefGoogle Scholar
  90. Van Beresteyn ECH, Schaafsma G, de Waard H (1986) Oral calcium and blood pressure: a controlled intervention trial. Am J Clin Nutr 44:883–888PubMedGoogle Scholar
  91. Varner MW, Cruikshank DP, Pitkin RM (1983) Calcium metabolism in the hypertensive mother, fetus and newborn. Am J Obstet Gynecol 147:762PubMedGoogle Scholar
  92. Villar J, Repke J, Belizan JM, Pareja G (1987) Calcium supplementation reduces blood pressure during pregnancy: results from a randomized controlled clinical trial. Obstet Gynecol 70:317–322Google Scholar
  93. Vinson JA, Mazur T, Bose P (1987) Comparison of different forms of calcium on blood pressure of normotensive young males. Nutr Rep Int 36:497–505Google Scholar
  94. Watt GCM, Edwards C, Hart JT, Hart M, Walton P, Foy CJW (1983) Dietary sodium restriction for mild hypertension in general practice. Br Med J 286:432–436CrossRefGoogle Scholar
  95. Webb REC, Bohr DF (1981) Recent advances in the pathogenesis of hypertension: consideration of structural, functional, and metabolic vascular abnormalities resulting in elevated vascular resistance. Am Heart J 102:251–264PubMedCrossRefGoogle Scholar
  96. Wittemann JCM, Willett WC, Stampfer MJ, Colditz GA, Sacks FM, Rosner B, Speizer FE, Hennekens CH (1987) Dietary calcium and magnesium and hypertension: a prospective study (abstract). Circulation 76[SupplIV]:35Google Scholar
  97. Yamamoto M, Kuller L (1985) Calcium and elevated blood pressure — further evidence from the three-area stroke mortality study (1971–1974) Am J Epidemiol 122:512Google Scholar
  98. Yang R-H, Jin H, Chen Y-F, Oparil S, Wyss JM (1988) Dietary calcium supplementation prevents the exaggerated responsiveness of anterior hypothalamic a2 adrenoceptors in NaCl-loaded spontaneously hypertensive rats. J Cardiovasc Pharm (in press)Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • D. A. McCarron
  • E. W. Young
  • R. D. Bukoski
  • C. D. Morris

There are no affiliations available

Personalised recommendations