Acute effects of calcium supplements on blood pressure: randomised, crossover trial in postmenopausal women

Billington, Emma O; Bristow, Sarah; Gamble, Greg; Kwant, J. A. de; Stewart, Angela; Mihov, Borislav; Horne, Anne; Reid, Ian R.

doi:10.1007/s00198-016-3744-y

Cited by 8 publications

(9 citation statements)

References 47 publications

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“…There is direct experimental evidence that raising serum calcium raises blood pressure [ 23 24 ], possibly mediated by changes in intracellular calcium which regulates vascular smooth muscle contraction. These changes might account for the higher blood pressures, compared with controls, observed following acute ingestion of calcium supplements [ 25 26 ]. A randomised controlled trial (RCT) of a calcium-fortified milk over 2 years, demonstrated an increase in aortic calcification in those randomised to the milk [ 27 ], calcium supplements increased carotid intima-media thickness in a RCT of postmenopausal women [ 28 ], and calcium supplement use is associated with increased risk of developing coronary artery calcification [ 29 ].…”

Section: Mechanisms Of the Calcium-vascular Disease Connectionmentioning

confidence: 99%

Calcium and Cardiovascular Disease

2017

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Circulating calcium is a risk factor for vascular disease, a conclusion arising from prospective studies involving hundreds of thousands of participants and extending over periods of up to 30 years. These associations may be partially mediated by other cardiovascular risk factors such as circulating lipid levels, blood pressure, and body mass index, but there appears to be a residual independent effect of serum calcium. Polymorphisms of the calcium-sensing receptor associated with small elevations of serum calcium are also associated with cardiovascular disease, suggesting that calcium plays a causative role. Trials of calcium supplements in patients on dialysis and those with less severe renal failure demonstrate increased mortality and/or acceleration of vascular disease, and meta-analyses of trials in those without overt renal disease suggest a similar adverse effect. Interpretation of the latter trials is complicated by a significant interaction between baseline use of calcium supplements and the effect of randomisation to calcium in the largest trial. Restriction of analysis to those who are calcium-naive demonstrates a consistent adverse effect. Observational studies of dietary calcium do not demonstrate a consistent adverse effect on cardiovascular health, though very high or very low intakes may be deleterious. Thus, obtaining calcium from the diet rather than supplements is to be encouraged.

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Section: Mechanisms Of the Calcium-vascular Disease Connectionmentioning

confidence: 99%

Calcium and Cardiovascular Disease

2017

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“…However, our study showed an increase in ionized calcium levels of 0.02 mmol/L 4 h after milk intake compared with water intake. This increase may not be large enough to cause the same negative effects as seen by Billington et al 4 However, it may be questioned whether an acute rise in calcium levels actually affects cardiovascular health in The Swedish mammography cohort found that a daily calcium intake above 1400 mg was associated with increased death rates from all causes and CVD except for stroke. 3 Thus, the lower calcium intake in the present study may explain why we found no effect on cardiovascular parameters.…”

Section: Discussionmentioning

confidence: 96%

“…However, our study showed an increase in ionized calcium levels of 0.02 mmol/L 4 h after milk intake compared with water intake. This increase may not be large enough to cause the same negative effects as seen by Billington et al 4 However, it may be questioned whether an acute rise in calcium levels actually affects cardiovascular health in an adverse manner. In a study by Burt et al, 5 administration of a single oral dose of 1000 mg calcium citrate did not increase arterial stiffness (PVW), but decreased AIx, despite increasing ionized calcium levels by 0.1 mmol/L.…”

Section: Discussionmentioning

confidence: 97%

“…Likewise, a Swedish community‐based cohort study found that a high intake of calcium (>1400 mg/day) in women was associated with higher death rates from all causes and cardiovascular disease (CVD) but not from stroke 3 . A recent randomized crossover trial has suggested a relative increase in blood pressure in the hours following intake of 1000 mg of calcium citrate compared with placebo 4 . In contrast, Burt et al 5 found no effect on arterial stiffness and a decrease in arterial wave reflection (augmentation index [Aix]) in the hours following intake of 1000 mg of calcium as citrate 5 .…”

Section: Introductionmentioning

confidence: 99%

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The acute effects of milk intake on calcium homeostasis and cardiovascular outcome: A randomized crossover trial in postmenopausal women

Espersen

Rejnmark

2021

Clinical Endocrinology

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Objective The importance of calcium intake from dairy in regard to cardiovascular health has been investigated in several studies with discrepant results. Hence, we aim to investigate the immediate effects of milk intake on cardiovascular function. Design A randomized crossover study with at least 10 days for washout between the two interventions, 500 ml of water with 200 µg of cholecalciferol or 500 ml of semi‐skimmed milk containing approximately 600 mg of calcium with 200 µg of cholecalciferol. Patients Twenty community‐based postmenopausal women aged 60–80 years. Measurements Parathyroid hormone and ionized calcium were measured at baseline and after 2 and 4 h on each study day. Pulse wave analysis and velocity were measured at baseline and after 4 h on each study day. Results Compared to water, milk intake increased ionized calcium levels by 0.02 mmol/L (p = .029) and decreased parathyroid hormone levels by 1.78 pmol/L (p < .001). The two interventions caused no changes as measured 4 h after the intervention in the following indices of cardiovascular health; pulse wave velocity, brachial diastolic or systolic blood pressure, central diastolic or systolic blood pressure, mean arterial pressure, pulse pressure, augmentation pressure, augmentation index, heart rate or pulse transit time. Conclusions Despite significant changes in calcium homeostasis with increased levels of ionized calcium following milk intake, no acute effects seem to occur on measures of cardiovascular health.

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“…Blood pressure was recorded at 2 h, 4 h and 6 h after calcium or placebo ingestion and found that both the SBP and DBP decreased significantly (−6 and −9 mmHg, respectively). The authors concluded that the use of calcium supplements in postmenopausal women could help reduce high blood pressure [25]. However, a few years ago, several research groups reported on the harmful effects of using calcium supplements with regards to vascular events in healthy postmenopausal women with a low calcium intake or osteoporosis [26][27][28], and despite intervention studies promoting its consumption [29], the use of calcium supplements in this population has been questioned on an ongoing basis [30].…”

Section: Discussionmentioning

confidence: 99%

A Dairy Product to Reconstitute Enriched with Bioactive Nutrients Stops Bone Loss in High-Risk Menopausal Women without Pharmacological Treatment

et al. 2020

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Osteoporosis is a multifactorial disease characterized by the loss of bone mass and deterioration of the internal structure of the bone, increasing the risk of fractures, and is becoming an economic and social problem. The main treatment is pharmacological, however, the population demands other therapies, such as foods with nutrients beneficial to bone health. Seventy-eight healthy menopausal women at risk of osteoporosis or untreated osteopenia were recruited for a randomized, parallel, double-blind clinical trial with two intervention groups: one group consumed a serving a day of the experimental enriched product (experimental group (EG)) and the other group (control group (CG)) consumed the same product without enrichment. The main objective was to compare the effect of consuming a dairy preparation to reconstitute, similar to yogurt when prepared, enriched in calcium, vitamin D, vitamin K, vitamin C, zinc, magnesium, L-leucine and probiotic (Lactobacillus plantarum 3547) on bone metabolism markers for 24 weeks. The EG showed a significantly increased bone mass compared to the CG (0.01 ± 0.03 vs. −0.01 ± 0.03 kg; p < 0.05). In addition, the EG maintained their bone mineral density (BMD) compared to the CG, whose BMD significantly decreased at the end of the study. For biochemical markers, the EG significantly increased the serum levels of the N-terminal propeptide of type I collagen (P1NP) bone formation marker (13.19 ± 25.17 vs. −4.21 ± 15.62 ng/mL; p < 0.05), and decreased the carbo-terminal telopeptide of type I collagen (CTx) bone resorption marker compared to the CG (−0.05 ± 0.19 vs. 0.04 ± 0.14 ng/mL; p < 0.05). On the other hand, the EG exhibited a significantly decreased systolic and diastolic blood pressure compared to the start of the study. Finally, the EG significantly increased their dietary calcium and vitamin D intake compared to the CG. In conclusion, the regular consumption of a dairy product to reconstitute enriched with bioactive nutrients improves bone health markers in menopausal women at risk of osteoporosis without pharmacological treatment.

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Acute effects of calcium supplements on blood pressure: randomised, crossover trial in postmenopausal women

Cited by 8 publications

References 47 publications

Calcium and Cardiovascular Disease

Calcium and Cardiovascular Disease

The acute effects of milk intake on calcium homeostasis and cardiovascular outcome: A randomized crossover trial in postmenopausal women

A Dairy Product to Reconstitute Enriched with Bioactive Nutrients Stops Bone Loss in High-Risk Menopausal Women without Pharmacological Treatment

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