Relation Between Low Calcium Intake, Parathyroid Hormone, and Blood Pressure

There is increasing epidemiologic and animal evidence that a low calcium diet increases blood pressure. The aim of this review is to compile the information on the link between low calcium intake and blood pressure. Calcium intake may regulate blood pressure by modifying intracellular calcium in vascular smooth muscle cells and by varying vascular volume through the renin–angiotensin–aldosterone system. Low calcium intake produces a rise of parathyroid gland activity. The parathyroid hormone increases intracellular calcium in vascular smooth muscles resulting in vasoconstriction. Parathyroidectomized animals did not show an increase in blood pressure when fed a low calcium diet as did sham-operated animals. Low calcium intake also increases the synthesis of calcitriol in a direct manner or mediated by parathyroid hormone (PTH). Calcitriol increases intracellular calcium in vascular smooth muscle cells. Both low calcium intake and PTH may stimulate renin release and consequently angiotensin II and aldosterone synthesis. We are willing with this review to promote discussions and contributions to achieve a better understanding of these mechanisms, and if required, the design of future studies.

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Acute effect of parathyroid hormone-(1–34) fragment on blood pressure in rats fed a low calcium diet

General Pharmacology The Vascular System ◽

10.1016/0306-3623(90)90712-u ◽

1990 ◽

Vol 21 (4) ◽

pp. 547-549 ◽

Cited By ~ 4

Author(s):

Akifumi Togari ◽

Sumio Shintani ◽

Michitsugu Arai ◽

Shosei Matsumoto ◽

Toshiharu Nagatsu

Keyword(s):

Blood Pressure ◽

Parathyroid Hormone ◽

Acute Effect ◽

Calcium Diet ◽

Low Calcium Diet ◽

Low Calcium

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Parathyroid hormone secretion in low calcium intake smokers

British Journal Of Nutrition ◽

10.1079/bjn2001405 ◽

2001 ◽

Vol 86 (2) ◽

pp. 307-307

Author(s):

D. Bonofiglio ◽

S. Catalano ◽

M. Maggiolini ◽

S. Andò

Keyword(s):

Parathyroid Hormone ◽

Calcium Intake ◽

Hormone Secretion ◽

Low Calcium

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Association between calcium intake, parathormone levels and blood pressure during pregnancy.

Colombia Medica ◽

10.25100/cm.v40i2.641 ◽

1969 ◽

Vol 40 (2) ◽

pp. 185-193

Author(s):

Aníbal Nieto ◽

Julián A. Herrera ◽

José Villar ◽

Roberto Matorras ◽

Carlos López de la Manzanara ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Calcium Intake ◽

Regression Models ◽

Statistical Association ◽

Linear Regression Models ◽

High Systolic Blood Pressure ◽

Low Calcium ◽

Nitrite Nitrate ◽

A Prospective Study

Purpose: To evaluate the association between calcium intake from diet, calciotropic hormones (PTH, PTH-rp), vasoactive regulators (endothelin, nitric oxide) and blood pressure levels during pregnancy, birth and puerperium. Method: In a prospective study 149 healthy normotensive primigravidas were followed-up from 15 weeks of gestation to puerperium. Daily calcium intake, calciuria, PTH, PTH-rp, endothelin, nitrite-nitrate, and Holter Test were assessed. Linear regression models were performed to evaluate the association between calcium intake, blood pressure levels and the laboratory tests. Multivariate regression models were performed to control potential confounders. Results: A significant increase of calcium intake during pregnancy was observed (931±301 mg/day to 1,195±467 mg/day, p< 0.001). Plasma PTH-rp, endothelin, and nitrite-nitrate levels did not change during pregnancy. Among the women 38 (25.4%) had low calcium intake (< 800 mg/day) with a larger increase of systolic and diastolic blood pressure during pregnancy (p=0.04) birth (p=0.006) and puerperium (p=0.01). After adjusting for other factors the multivariate analyses showed statistical association between low calcium intake, high parathormone levels and high systolic blood pressure levels during pregnancy (p=0.002). Conclusion: Low calcium intake during pregnancy is associated with a larger increase of systolic blood pressure and high parathormone levels.

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Relationship of blood pressure, calcium intake, and parathyroid hormone

American Journal of Clinical Nutrition ◽

10.1093/ajcn/49.1.183a ◽

1989 ◽

Vol 49 (1) ◽

pp. 183-184 ◽

Cited By ~ 3

Author(s):

J Villar ◽

J Repke ◽

J Belizan

Keyword(s):

Blood Pressure ◽

Parathyroid Hormone ◽

Calcium Intake ◽

Relationship Of

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Increased calcium intake reduces plasma cholesterol and improves vasorelaxation in experimental renal failure

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.01148.2002 ◽

2003 ◽

Vol 285 (5) ◽

pp. H1882-H1889 ◽

Cited By ~ 14

Author(s):

Pasi Jolma ◽

Peeter Kööbi ◽

Jarkko Kalliovalkama ◽

Mika Kähönen ◽

Meng Fan ◽

...

Keyword(s):

Blood Pressure ◽

Renal Failure ◽

Parathyroid Hormone ◽

Calcium Intake ◽

Plasma Cholesterol ◽

Plasma Phosphate ◽

Plasma Total Cholesterol ◽

Calcium Diet ◽

High Calcium ◽

High Calcium Diet

Chronic renal failure (CRF) is associated with abnormal lipid metabolism and high prevalence of vascular complications. Calcium salts are commonly used in CRF as phosphate binders. Increased calcium intake may also lower plasma cholesterol and beneficially influence vascular tone. Therefore, we investigated the influence of increasing dietary calcium from 0.3% to 3.0% for 8 wk after 5/6 nephrectomy (NTX) on plasma cholesterol and mesenteric resistance vessel tone in male Sprague-Dawley rats. The groups were Sham, Sham-Calcium, NTX, and NTX-Calcium ( n = 10–11). Blood pressure was modestly elevated after NTX, whereas the plasma creatinine, urea nitrogen, phosphate, and parathyroid hormone levels were clearly increased. The high-calcium diet suppressed plasma phosphate and parathyroid hormone but was without effect on blood pressure. The NTX resulted in 1.6-fold elevation in plasma total cholesterol and 40% reduction in high density-to-low density lipoprotein ratio (HDL/LDL). However, the lipid profile in NTX rats on the high-calcium diet did not differ from sham-operated controls. The endothelium-mediated relaxations induced by acetylcholine were impaired in NTX rats, whereas the response was normalized by a high-calcium diet. No differences in vasorelaxations by the endothelium-independent vasodilator nitroprusside were detected. In conclusion, improved vasorelaxation after a high-calcium diet could be due to reduced plasma total cholesterol and ameliorated HDL/LDL ratio, although decreased plasma phosphate and parathyroid hormone may also play a significant role in the vascular effects of increased calcium intake.

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Randomized, placebo-controlled, calcium supplementation trial in pregnant Gambian women accustomed to a low calcium intake: effects on maternal blood pressure and infant growth

American Journal of Clinical Nutrition ◽

10.3945/ajcn.113.059923 ◽

2013 ◽

Vol 98 (4) ◽

pp. 972-982 ◽

Cited By ~ 14

Author(s):

Gail R Goldberg ◽

Landing MA Jarjou ◽

Tim J Cole ◽

Ann Prentice

Keyword(s):

Blood Pressure ◽

Calcium Intake ◽

Calcium Supplementation ◽

Maternal Blood ◽

Infant Growth ◽

Low Calcium ◽

Maternal Blood Pressure

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Association of bone microarchitecture with parathyroid hormone concentration and calcium intake in men: the STRAMBO study

Acta Endocrinologica ◽

10.1530/eje-11-0184 ◽

2011 ◽

Vol 165 (1) ◽

pp. 151-159 ◽

Cited By ~ 27

Author(s):

A Chaitou ◽

S Boutroy ◽

N Vilayphiou ◽

A Varennes ◽

M Richard ◽

...

Keyword(s):

Vitamin D ◽

Parathyroid Hormone ◽

Bone Turnover ◽

Calcium Intake ◽

Bone Microarchitecture ◽

Quantitative Computed Tomography ◽

Distal Tibia ◽

Volumetric Bone Mineral Density ◽

Mineral Density ◽

Low Calcium

ObjectiveIn the elderly, vitamin D deficit, low calcium intake, and impaired bone microarchitecture are associated with higher risk of hip fracture. We assessed the association of bone microarchitecture with calcium intake and serum concentrations of 25-hydroxycholecalciferol (25OHD) and parathyroid hormone (PTH) in men.DesignCross-sectional analysis was performed in 1064 men aged 20–87 years not taking vitamin D or calcium supplements.MethodsDaily calcium intake was assessed using a food frequency questionnaire. Bone microarchitecture was assessed at distal radius and tibia by high-resolution peripheral quantitative computed tomography. We measured serum and urinary levels of biochemical bone turnover markers (BTMs). Statistical models were adjusted for age, weight, height, and glomerular filtration rate.ResultsIn 500 men aged <65 years, lower 25OHD levels and low calcium intake were associated with lower trabecular volumetric bone mineral density (Dtrab) at the distal tibia, due to lower trabecular number (Tb.N). Low calcium intake was associated with lower cortical thickness (Ct.Th). Higher PTH level was associated with higher BTM levels. In 563 men aged ≥65 years, the highest PTH quartile was associated with lower Ct.Th (tibia), lower Dtrab (both sites), and lower Tb.N (radius) compared with the lowest quartile. Low calcium intake was associated with lower Tb.N and more heterogenous trabecular distribution. BTM positively correlated with the PTH concentration.ConclusionIn older men, elevated PTH concentration is associated with high bone turnover, poor trabecular microarchitecture (radius and tibia), and, at the distal tibia, lower Ct.Th. Low calcium intake is associated with lower Tb.N and more heterogenous trabecular distribution.

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Effects of Mineral Composition of Drinking Water on Risk for Stone Formation and Bone Metabolism in Idiopathic Calcium Nephrolithiasis

Clinical Science ◽

10.1042/cs0910313 ◽

1996 ◽

Vol 91 (3) ◽

pp. 313-318 ◽

Cited By ~ 31

Author(s):

Martino Marangella ◽

Corrado Vitale ◽

Michele Petrarulo ◽

Lidia Rovera ◽

Franca Dutto

Keyword(s):

Drinking Water ◽

Parathyroid Hormone ◽

Bone Resorption ◽

Calcium Oxalate ◽

Calcium Intake ◽

Mineral Water ◽

Stone Formation ◽

Low Calcium ◽

High Calcium ◽

Markers Of Bone Resorption

1. To assess whether the mineral content of drinking water influences both risk of stone formation and bone metabolism in idiopathic calcium nephrolithiasis, 21 patients were switched from their usual home diets to a 10 mmol calcium, low-oxalate, protein-controlled diet, supplemented with 21 of three different types of mineral water. Drinking water added 1, 6 and 20 mmol of calcium and 0.5, 10 and 50 mmol of bicarbonate respectively to the controlled diet. 2. The three controlled study periods lasted 1 month each and were separated by a 20 day washout interval. Blood and urine chemistries, including intact parathyroid hormone, calcitriol and two markers of bone resorption, were performed at the end of each study period. The stone-forming risk was assessed by calculating urine saturation with calcium oxalate (βCaOx), calcium phosphate (βbsh) and uric acid (βUA). 3. The addition of any mineral water produced the expected increase in urine output and was associated with similar decreases in βCaOx and βUA, whereas βbsh varied marginally. These equal decreases in βCaOx, however, resulted from peculiar changes in calcium, oxalate and citrate excretion during each study period. The increase in overall calcium intake due to different drinking water induced modest increases in calcium excretion, whereas oxalate excretion tended to decrease. The changes in oxalate excretion during any one study period compared with another were significantly related to those in calcium intake. Citrate excretion was significantly higher with the high-calcium, alkaline water. 4. Parathyroid hormone, calcitriol and markers of bone resorption increased when patients were changed from the high-calcium, alkaline to the low-calcium drinking water. 5. We suggest that overall calcium intake may be tailored by supplying calcium in drinking water. Adverse effects on bone turnover with low-calcium diets can be prevented by giving high-calcium, alkaline drinking water, and the stone-forming risk can be decreased as effectively as with low-calcium drinking water.

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