Blood pressure response to calcium supplementation: a meta-analysis of randomized controlled trials

Mierlo, Linda A. J. van; Arends, Lidia R.; Streppel, Martinette T; Zeegers, Maurice P.; Kok, F.J.; Grobbee, Diederick E.; Geleijnse, Johanna M.

doi:10.1038/sj.jhh.1002038

Cited by 240 publications

(162 citation statements)

References 49 publications

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“…It has been proposed that the bloodpressure-lowering effects of calcium supplementation alone tend to be greatest in those with the lowest dietary calcium intakes (o600 mg per day) before supplementation (Reid et al, 2005) and/or those who are hypertensive (Allender et al, 1996). Similarly, several meta-analyses have failed to detect a blood-pressure-lowering effect of calcium supplementation with intakes around 1000-1200 mg per day in groups with a wide range of usual calcium intakes (Dickinson et al, 2006;van Mierlo et al, 2006). Furthermore, because only approximately 30% of the men in our study were classified as hypertensive at baseline, it is possible that the lack of an effect of calcium plus vitamin D 3 supplementation in our study, and in several previous trials (Orwoll and Oviatt, 1990;Pan et al, 1993;Major et al, 2007), was due to the fact that the participants in our study had adequate calcium intakes (B1000 mg per day) and serum 25(OH)D concentrations (B75 nmol/l) and/or were normotensive before supplementation.…”

Section: Discussionmentioning

confidence: 99%

Long-term effect of calcium-vitamin D3 fortified milk on blood pressure and serum lipid concentrations in healthy older men

Daly

Nowson

2009

Eur J Clin Nutr

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Background/Objectives: Some epidemiological and clinical studies have shown that increased dairy consumption or calcium and/or vitamin D supplementation can have a beneficial effect on blood pressure, and lipid and lipoprotein concentrations. The aim of this study was to assess the long-term effects of calcium-vitamin D 3 fortified milk on blood pressure and lipid-lipoprotein concentrations in community-dwelling older men. Subjects/Methods: This is a substudy of a 2-year randomized controlled trial in which 167 men aged 450 years were assigned to receive either 400 ml per day of reduced fat (B1%) milk fortified with approximately 1000 mg of calcium and 800 IU of vitamin D 3 or to a control group receiving no additional fortified milk. Weight, blood pressure, lipid and lipoprotein concentrations were measured every 6 months. Participants on lipid-lowering (n ¼ 32) or antihypertensive medication (n ¼ 39) were included, but those who commenced, increased or decreased their medication throughout the intervention were excluded (n ¼ 27). Results: In the 140 men included in this study (milk, n ¼ 73; control, n ¼ 67), there were no significant effects of the calciumvitamin D 3 fortified milk on weight, systolic or diastolic blood pressure, total cholesterol, high-density lipoprotein or low-density lipoprotein cholesterol or triglyceride concentrations at any time throughout the intervention. Similar results were observed after excluding men taking antihypertensive or lipid-lowering medication or limiting the analysis to those with baseline calcium intakes o1000 mg per day and/or with hypovitaminosis D (25(OH)D o75 nmol/l). Conclusions: Supplementation with reduced-fat calcium-vitamin D 3 fortified milk did not have a beneficial (nor detrimental) effect on blood pressure, lipid or lipoprotein concentrations in healthy community-dwelling older men.

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Section: Discussionmentioning

confidence: 99%

Long-term effect of calcium-vitamin D3 fortified milk on blood pressure and serum lipid concentrations in healthy older men

Daly

Nowson

2009

Eur J Clin Nutr

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“…63 Vitamin E is a weak antioxidant that increases the circulating levels of vitamin C. 64 Vitamin E should be limited to 200 IU and should not be taken with aspirin. 16 Substituting green tea for other beverages, together with 1000 mg of vitamin C and 200 mg of vitamin E daily, would be the least expensive choice for achieving good levels of antioxidants.…”

Section: Other Factorsmentioning

confidence: 99%

Lifestyle and metabolic approaches to maximizing erectile and vascular health

et al. 2011

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Oxidative stress and inflammation, which disrupt nitric oxide (NO) production directly or by causing resistance to insulin, are central determinants of vascular diseases including ED. Decreased vascular NO has been linked to abdominal obesity, smoking and high intakes of fat and sugar, which all cause oxidative stress. Men with ED have decreased vascular NO and circulating and cellular antioxidants. Oxidative stress and inflammatory markers are increased in men with ED, and all increase with age. Exercise increases vascular NO, and more frequent erections are correlated with decreased ED, both in part due to stimulation of endothelial NO production by shear stress. Exercise and weight loss increase insulin sensitivity and endothelial NO production. Potent antioxidants or high doses of weaker antioxidants increase vascular NO and improve vascular and erectile function. Antioxidants may be particularly important in men with ED who smoke, are obese or have diabetes. Omega-3 fatty acids reduce inflammatory markers, decrease cardiac death and increase endothelial NO production, and are therefore critical for men with ED who are under age 60 years, and/or have diabetes, hypertension or coronary artery disease, who are at increased risk of serious or even fatal cardiac events. Phosphodiesterase inhibitors have recently been shown to improve antioxidant status and NO production and allow more frequent and sustained penile exercise. Some angiotensin II receptor blockers decrease oxidative stress and improve vascular and erectile function and are therefore preferred choices for lowering blood pressure in men with ED. Lifestyle modifications, including physical and penile-specific exercise, weight loss, omega-3 and folic acid supplements, reduced intakes of fat and sugar, and improved antioxidant status through diet and/or supplements should be integrated into any comprehensive approach to maximizing erectile function, resulting in greater overall success and patient satisfaction, as well as improved vascular health and longevity.

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“…Epidemiological as well as intervention studies have shown an inverse relationship between Ca intake and blood pressure (37,38) . Several potential mechanisms may explain the positive effect of Ca on blood pressure, including reduced membrane permeability to monovalent and divalent cations, reduced intracellular Ca levels, decreased concentrations of Ca-regulating hormones, reduced sympathetic nervous system activity, and altered metabolism of other electrolytes, for example, increased Na excretion (39) .…”

Section: Effects Of Calcium On Blood Pressurementioning

confidence: 99%

Dairy product consumption and the metabolic syndrome

2008

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The metabolic syndrome is an important risk factor for type 2 diabetes mellitus and CVD. Epidemiological studies have now suggested protective effects of dairy product consumption on the development of this syndrome. Here we review the physiological effects and possible mechanisms involved of three main dairy constituents (Ca, protein, fat) on important components of the metabolic syndrome. Ca supplements improve the serum lipoprotein profile, particularly by decreasing serum total and LDL-cholesterol concentrations. They also lower systolic and diastolic blood pressure. Insufficient evidence exists for a significant role of Ca supplements or dairy in body-weight management. Effects of Ca may be related to intestinal binding to fatty acids or bile acids, or to changes in intracellular Ca metabolism by suppressing calciotropic hormones. Dietary proteins may increase satiety in both the short and longer term, which may result in a reduced energy intake. They have also been reported to improve the serum lipoprotein profile as compared with carbohydrates. Dairy proteins are precursors of angiotensin-I-converting enzyme-inhibitory peptides, which may lower blood pressure. Such effects, however, have inconsistently been reported in human studies. Finally, conjugated linoleic acid, which effectively lowers body weight in animals, has no such effect in humans in the quantities provided by dairy products. To reduce the intake of SFA, the consumption of low-fat instead of high-fat dairy products is recommended. In conclusion, more research is warranted to better understand the physiological effects and the mechanisms involved of dairy products in the prevention and treatment of the metabolic syndrome.

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Blood pressure response to calcium supplementation: a meta-analysis of randomized controlled trials

Cited by 240 publications

References 49 publications

Long-term effect of calcium-vitamin D3 fortified milk on blood pressure and serum lipid concentrations in healthy older men

Long-term effect of calcium-vitamin D3 fortified milk on blood pressure and serum lipid concentrations in healthy older men

Lifestyle and metabolic approaches to maximizing erectile and vascular health

Dairy product consumption and the metabolic syndrome

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