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Article Review/Hyperlink
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Allender FS, Cutler JA, Follmann D, Cappuccio LP, Prer J,
Elliott P
Dietary calcium and blood pressure: A meta-analysis of
randomized clinical trials
Ann Int Med
(May) 124:825-831 1996

Objective: To determine the effect of dietary calcium
supplementation on blood pressure.
Methods: A meta-analysis based on a manual and
MEDLINE search of published reports and review of meeting abstracts.
Results: 26 randomized trials were found; 13 involved
normotensives and 16 hypertensives (3 trials included both). Four
trials were excluded because of inadequate data, multifactorial
intervention, absence of an effect estimate, and faulty study design.
28 strata from 22 trials (1231 persons) were included in the final
analysis. The effect of calcium supplementation (median dose 1 g/d)
on blood pressure was -0.18 mm Hg for diastolic blood pressure and
-0.89 mm Hg for systolic blood pressure. The change in systolic
pressure was stastically significant. This effect was seen in
hypertensive but not normotensive persons. The decrease in sytolic
pressure was most marked in older hypertensive women.
Conclusions: Although there is a stastifcally
significant reduction in systolic blood pressure with calcium
supplements in hypertensives, the effect is of questionable clinical
significance.
Comment: This is a well-done meta-analysis and the results are
of interest, given the uncertain role of calcium intake on blood
pressure. It is of note that only one study has shown a convincing
calcium-induced decrease in systolic blood pressure (McCarron and
Morris, 1985); diastolic blood pressure has not decreased in any of
the reported trials. However, it should be noted that calcium
supplementation has never been shown to have a deterimental effect on
blood pressure and although there is concern that it could have other
deleterious effects such as increased kidney stones in stone formers,
this is unproven. It is of interest that the effect of calcium on
systolic pressure appears to be greatest in older women, the
population in whom calcium supplements are often prescribed to prevent
or treat osteoporosis. (David J. Leehey, M.D., Loyola University at
Chicago)
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