Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Quality Enhancement Research Initiative.

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Abstract-Total serum calcium levels were measured in 12 865 men and 14 293 women, between the ages of 25 and 97 years, in the Tromsø Study during 1994 and 1995. With the use of a sex-specific multiple linear regression model with age, calcium, body mass index, cholesterol, HDL cholesterol, triglycerides, systolic and diastolic blood pressure, and pulse as possible covariates, serum calcium was significantly (PϽ0.001) and positively associated with systolic and diastolic blood pressure, serum cholesterol, and HDL cholesterol in both sexes. A similar but weaker association was observed between serum calcium and triglycerides in men (PϽ0.01). In all age groups, serum calcium levels were higher in men with a history of myocardial infarction than in those without, and the difference was significant (PϽ0.0001) in a linear regression analysis adjusted for age. When all the other variables were also included in a logistic regression model, serum calcium was a highly significant (PϽ0.0001) predictor of myocardial infarction in men, with an odds ratio of 1.2 per 0.1 mmol/L increase in serum calcium. In women, a nonsignificant trend was again seen. Because the free or ionized form of calcium is the physiologically important form and serum calcium was not corrected for serum albumin in our study, the results must be interpreted with caution. However, it appears likely that serum calcium is a predictor of cardiovascular disease in men. (Hypertension. 1999;34:484-490.)Key Words: calcium Ⅲ blood pressure Ⅲ cholesterol Ⅲ triglycerides Ⅲ cardiovascular diseases I n epidemiological studies, serum calcium has been found to increase with increasing levels of systolic and diastolic blood pressure (BP). 1,2 Furthermore, in patients with hyperparathyroidism and therefore chronic hypercalcemia, hypertension is prevalent 3 and an increased mortality rate exists, particularly from cardiovascular diseases. 4 Serum calcium has also been found to correlate with serum cholesterol and blood glucose 2 and therefore is apparently associated with the metabolic syndrome. Recently, serum calcium has been reported to be an independent, prospective risk factor for myocardial infarction in middle-aged men. 5 In the municipality of Tromsø, which is located in northern Norway, 4 large health surveys have been performed, the first in 1974 and the last in 1994 -1995. The Tromsø studies have primarily focused on cardiovascular risk factors and diseases, and in the last study, serum calcium was also analyzed. Because Ͼ27 000 persons were examined, a large database was therefore available to study relationships between serum calcium and risk factors for coronary heart disease. Methods SubjectsIn 1994 -1995, all men and women who were Ͼ24 years of age and who lived in the municipality of Tromsø were invited to participate in a health survey performed by the National Health Screening Service in cooperation with the University of Tromsø and local health authorities. Generally, this health survey was conducted in a manner similar to previous studies. 6 A questi...

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