Calcium and Primary Hypertension

Abstract

The role of dietary calcium in essential hypertension remains controversial. Various studies have found on the one hand a weak negative correlation between blood pressure and Ca²⁺ intake in special groups, and on the other hand a positive correlation between serum Ca²⁺ concentration and blood pressure. Several disturbances of cellular Ca²⁺ metabolism have been described in essential hypertension and in the spontaneously hypertensive rat. Possibly the elevation of intracellular free Ca²⁺ concentration in arterial smooth muscle cells is one important step in the pathogenesis of primary hypertension. In most studies a decreased energy-dependent Ca²⁺ transport has been proposed as a mechanism. However, disturbances in cellular Ca²⁺ metabolism, which can be exclusively ascribed to essential hypertension, have not yet been found. The cause of altered cellular Ca²⁺ transport in primary hypertension may either be a genetically determined defect of membrane transport or a still unidentified humoral factor.

Serum Calcium Levels and Hypertension Among US Adults

“…Our finding of a positive association between elevated serum total calcium levels and hypertension is consistent with several previous studies 1,6–34 . Jorde and colleagues, in a large cross‐sectional study of 12,865 men and 14,293 women in Norway, reported that serum total calcium was positively associated with hypertension in both men and women after adjusting for age, BMI, heart rate, and cholesterol 6 .…”

“…An association between serum total calcium and hypertension is plausible, including a direct effect on vasculature by enhanced vascular resistance, 19 alteration in extracellular binding of calcium, 20 interaction between serum calcium, and other cations such as sodium, potassium and magnesium, 21 renal vasoconstriction causing kidney dysfunction, 22 and hyperactivity of renin‐angiotensin system from hyperparathyroidism 23 . Animal studies have demonstrated elevated total calcium concentrations but normal ionized calcium levels in spontaneously hypertensive rats 24 .…”

Association Between Serum Calcium and the Prevalence of Hypertension Among US Adults

“…Serum calcium may directly affect vasoconstriction by the influx of calcium into the smooth muscle of the artery, which enhances muscle contracture, increases vascular resistance, and therefore, leads to the development of hypertension ( 43 ). Additionally, calcium could indirectly promote hypertension by alteration in the extracellular binding of calcium ( 44 ), inducing insulin resistance ( 38 ), and interacting with other cations, especially sodium and potassium ( 45 ). Another possible mechanism lies in that subtle alterations in intracellular calcium may affect the secretion and action of hormones, such as the pressor action of catecholamines, angiotensin II, or aldosterone, which may target the blood pressure control centers and increase blood pressure levels ( 6 ).…”

Body Composition and Serum Total Calcium Were Associated With Blood Pressure Among Children and Adolescents Aged 7–18 in China: A Cross-Sectional Study

“…Extracellular calcium level may influence intracellular calcium level and possibly play a role in the pathogenesis of essential HTN (41). The biological mechanisms underlie serum total calcium and blood pressure maybe attribute to a direct effect on vascular by enhanced vascular resistance (42), interaction between serum calcium and other cations (43), alteration in extracellular binding of calcium (44), renal vasoconstriction causing kidney dysfunction (45), and hyperactivity of renin-angiotensin system from hyperparathyroidism (46). Emerging studies have been focused on the role of serum calcium to blood pressure.…”