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(Hypertension. 1997;29:531.)
© 1997 American Heart Association, Inc.
State-of-the-Art-Lecture |
From the Hypertension Unit, Departments of Internal Medicine and Nephrology (E.P.), Hospital Clínic, University of Barcelona, Spain.
Correspondence to Alejandro de la Sierra, MD, Hypertension Unit, Department of Internal Medicine, Hospital Clínic, Villarroel 170, 08036-Barcelona, Spain. E-mail iserte{at}medicina.ub.es
We evaluated the effect of oral calcium supplementation on blood pressure, calcium metabolism, and insulin resistance in essential hypertension. After receiving a standard diet with 500 mg of calcium per day during a 4-week period, 20 nondiabetic, essential hypertensive patients were randomized in a double-blind fashion to receive oral calcium supplementation (1500 mg of calcium per day) or placebo for 8 weeks. At the end of the 4-week period of low-calcium diet and after the 8-week period of intervention, we measured blood pressure (by both office and 24-hour ambulatory blood pressure monitoring), calcium-regulating hormones [urinary hydroxyproline and serum osteocalcin, parathormone, and 1,25(OH)2-vitamin D3], intra-platelet free calcium concentration, fasting plasma glucose and insulin levels, and the insulin-sensitivity index (euglycemic-hyperinsulinemic clamp). Compared with patients maintained at low calcium intake, essential hypertensive patients under oral calcium supplementation significantly reduced serum osteocalcin (from 22.2±1.9 to 17.9±2.0 µg/L; P=.0015), parathormone (from 4.20±0.38 to 3.30±0.36 pmol/L; P=.0003), and 1,25(OH)2-vitamin D3 (from 98.0±11.0 to 61.6±5.7 pmol/L; P=.0062). Likewise, we found a significant reduction in intraplatelet free calcium concentration (from 35.9±1.2 to 26.5±0.8 nmol/L; P=.0005) and fasting plasma insulin levels (from 71.8±5.9 to 64.6±6.2 pmol/L; P=.05) and a significant increase in the insulin-sensitivity index (from 2.89±0.77 to 4.00±0.95 mg·kg-1·-1; P=.0007). None of these parameters were significantly modified in patients maintained at low calcium intake. Office and 24-hour mean values of systolic and diastolic blood pressure did not change after 8 weeks of oral calcium supplementation or placebo.
Key Words: calcium, dietary calcium supplements intracellular free calcium insulin resistance hypertension
Abbreviations: ABPM = ambulatory blood pressure monitoring BP = blood pressure DBP = diastolic blood pressure Fura 2-AM = Fura 2-acetoxymethylester HBS = HEPES-buffered saline PRP = platelet-rich plasma SBP = systolic blood pressure
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