Alterations in calcium metabolism in young people at risk for primary hypertension. The Dutch Hypertension and Offspring Study.

Abstract

Several disturbances in calcium metabolism have been reported in primary hypertensive subjects. It is, however, not clear whether these alterations predate the development of hypertension or occur as a consequence of high blood pressure. We studied indexes of calcium metabolism in three groups of normotensive children with different familial predispositions for hypertension, based on parental blood pressure levels, with two, one, or no hypertensive parents. Plasma intact parathyroid hormone pressure regulation. In some hypertensive subjects, urinary excretion of magnesium may be decreased and show an inverse relation with blood pressure.16 Serum phosphate concentration is reported to be lower in hypertension and negatively related to blood pressure. 17Besides changes in serum and urinary electrolytes, raised circulating parathyroid hormone (PTH) levels have been demonstrated in hypertensive individuals. 1318 We reported previously that plasma intact PTH is raised in young hypertensive subjects compared with normotensive subjects of similar age, suggesting that alterations in calcium metabolism may be important in the early phase of primary hypertension. 1920Discussion remains as to whether changes in calcium metabolism are causally related to the development of high blood pressure. 21 In genetically hypertensive rats, calcium supplementation during the developmental phase of hypertension diminished the blood pressure increase. 22 In another study, however, genetically hypertensive rats fed a calcium-deficient diet did not show an increased blood pressure rise compared with rats fed a normal diet. 23 Parathyroidectomy in young genetically hypertensive rats, while keeping a normal serum calcium level, delayed the rise in systolic blood pressure for 42 weeks. 24 In humans, information on the part played by changes in calcium metabolism in the development of high blood pressure may be gained from comparison of

A pharmacogenetic approach to blood pressure in Lyon hypertensive rats. A chromosome 2 locus influences the response to a calcium antagonist.

“…Considerable evidence exists that calcium plays a central role in the regulation of vascular smooth muscle contraction and there is growing evidence in human and animal studies that alterations of calcium metabolism at either the systemic or cellular level may be involved in the pathogenesis of hypertension (26)(27)(28)(29). Moreover, similar alterations in calcium metabolism have been found in the normotensive offspring of hypertensive parents suggesting that they may be genetically determined (30). Of more direct relevance to the findings here, high calcium diet and parathyroidectomy in LH rats influence blood pressure and vascular reactivity (31,32).…”

High Blood Pressure, Bone-Mineral Loss and Insulin Resistance in Women

“…Abnormal calcium transport has been associated with essential hypertension (39). DeFronzo et al (13,14) reported that insulin might act on renal distal tubules to enhance calcium excretion in humans, promote cellular uptake of phosphate and enhance tubular reabsorption of phosphate at the proximal and distal tubules in dogs.…”

High Urinary Calcium Excretion and Genetic Susceptibility to Hypertension and Kidney Stone Disease

“…Normotensive offspring of hypertensive patients also have disturbed Ca 2ϩ metabolism, suggesting a possible genetic basis for these abnormalities (9,10). We previously reported familial aggregation of hypertension in patients with KSD and hypercalciuria and hyperuricosuria but not with either urinary abnormality alone (11,12).…”