Association of Habitually Low Intake of Dietary Calcium with Blood Pressure and Hypertension in a Population with Predominantly Plant-Based Diets

Abstract

This study aimed to assess the association of habitually low dietary calcium intake with blood pressure or hypertensive risk using data from the China Health and Nutrition Survey (CHNS) in 2009. We included 6298 participants (2890 men and 3408 women) aged 18 years or older in this analysis. Food intakes were measured by 3-day 24-h individual recalls combined with a weighing and measuring of household food inventory. The participants were divided into normotensive, pre-hypertensive and hypertensive groups according to their mean blood pressure of three repeated measurements. Six intake levels were decided by percentiles of gender-specific dietary calcium intakes (P0–10, P10–30, P30–50, P50–70, P70–90, and P90–100). Average dietary calcium intakes were 405 mg/day for men and 370 mg/day for women, 80% and 84% of which were derived from plant-based food in men and women, respectively. Multiple linear regression analyses showed that dietary calcium intakes were not related with blood pressure in both genders (all P > 0.05). Logistic regression analyses showed a lower risk of pre-hypertension with higher dietary calcium intakes in women (all Pfor trend < 0.001), but not in men; no association between dietary calcium intake and hypertensive risk was found in both genders (all Pfor trend > 0.05). This study suggests that there are no conclusive associations of habitually low dietary calcium intake with blood pressure or hypertensive risk in Chinese individuals consuming predominantly plant-based diets.

Rural and Urban Population Differences in the Association of Dietary Calcium with Blood Pressure and Hypertension Occurrence: Analysis of Longitudinal Data from the China Health and Nutrition Survey

“…Here, we found an increased hypertension risk in the UP; however, we observed no significant associations in the RP. Similarly, Ziqi et al found no significant association between DCI and hypertension in Chinese adults [22]. In our rural group, we identified a non-conclusive association of hypertension occurrence and DCI.…”

“…In the above-mentioned Cochrane study, there was no alteration effect of the calcium supplementation on the diastolic blood pressure [19]. A recent cohort study conducted in Chinese populations indicated inconclusive results on the consumption of calcium related to blood pressure or the risk of hypertension [22]. A prospective cohort study in 28,886 middle-aged and older women by Wang and colleagues showed a lower rate of hypertension in participants with high calcium consumption (1679 mg/day) (RR 1.12, 95% CI 1.05-1.20), while participants over 45 years of age with low calcium consumption (<558 mg/day) had a higher rate of hypertension [23].…”

Perspectives on the systematic review for the 2020 Dietary Reference Intakes for Koreans for calcium

“…Among studies reviewed for the relationship between Ca intake and blood pressure ( Table 6 ), the effect of Ca intake on the decrease in blood pressure was more significant in women compared to men [ 49 56 57 58 ]; however, there were also results that did not show significant positive effects in both women and men [ 43 49 53 ]. A cohort study found that the conjoint effects of serum Ca and insulin resistance at baseline on hypertension at follow-up [ 59 ].…”

Dietary calcium, magnesium, and phosphorus intakes and risk of stroke in Chinese adults

“…However, to our knowledge, little is known about the association of dietary calcium, magnesium, and phosphorus intakes with stroke incidence in the Chinese population. The average dietary intake of these micronutrients among Chinese individuals consuming predominantly plant-based diets was reported to be lower than that of Europeans and Americans who have more dairy and meat products 15 . In this context, a large-scale prospective study in the Chinese population to supplement the association's evidence is admittedly needed.…”