Dietary Calcium and Blood Pressure

doi:10.1059/0003-4819-124-9-199605010-00007

Dietary Calcium and Blood Pressure

A Meta-Analysis of Randomized Clinical Trials

P. Scott Allender, MD;
Jeffrey A. Cutler, MD, MPH;
Dean Follmann, PhD;
Francesco P. Cappuccio, MD, MSc;
Jane Pryer, PhD; and
Paul Elliott, PhD, MRCP

From the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, and the London School of Hygiene and Tropical Medicine, London, United Kingdom. Requests for Reprints: P. Scott Allender, MD, Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, II Rockledge Center, Room 8132, 6701 Rockledge Drive, Bethesda, MD 20892. Current Author Addresses: Drs. Allender, Cutler, and Follman: Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, II Rockledge Center, 6701 Rockledge Drive, MSC 7936, Bethesda, MD 20892. Drs. Cappuccio, Pryer, and Elliott: Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, Keppel Street, London WCIE 7HT, United Kingdom.

Abstract

Purpose: To assess the effect of dietary calcium supplementation on blood pressure.

Data Sources: Published reports of trials studying the effect of dietary calcium supplementation on blood pressure were identified by a search of previous reviews, a MEDLINE search, a manual review of journal articles, and a review of abstracts from scientific meetings.

Study Selection: Randomized clinical trials in which dietary calcium intake varied by intervention group were selected. Multifactorial trials were not included.

Data Synthesis: Data from 28 active treatment arms or strata from 22 randomized clinical trials were pooled using a weighted average method, with weights proportional to the inverse of the variance of the treatment effect. The total sample comprised 1231 persons. Because trials of both normotensive and hypertensive persons were included, subgroup analyses could be done. Pooled estimates of the effect of calcium supplementation on blood pressure were −0.18 mm Hg for diastolic blood pressure (95% CI, −0.75 to 0.40 mm Hg) and −0.89 mm Hg for systolic blood pressure (CI, −1.74 to −0.05 mm Hg). Pooled estimates for systolic blood pressure were −0.53 mm Hg (CI, −1.56 to 0.49 mm Hg) for trials of normotensive persons and −1.68 mm Hg (CI, −3.18 to −0.18 mm Hg) for trials of hypertensive persons. Diastolic blood pressure was not significantly affected in either subgroup.

Conclusion: The pooled estimate shows a statistically significant decrease of systolic blood pressure with calcium supplementation, both for hypertensive persons and for the overall sample. However, the effect is too small to support the use of calcium supplementation for preventing or treating hypertension.