Journal
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 86, Issue 4, Pages 1633-1637Publisher
ENDOCRINE SOC
DOI: 10.1210/jc.86.4.1633
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Calcium supplementation is effective in reducing blood pressure in various states of hypertension, including pregnancy-induced hypertension and preeclampsia. In addition, calcitropic hormones are associated with blood pressure. The hypothesis is that short-term therapy with calcium and vitamin D-3 may improve blood pressure as well as secondary hyperparathyroidism more effectively than calcium monotherapy. The effects of 8 weeks of supplementation with vitamin D-3 (cholecalciferol) and calcium on blood pressure and biochemical measures of bone metabolism were studied. The sample consisted of 148 women (mean +/- SD age, 74 +/- 1 yr) with a 25-hydroxycholecalciferol (250HD(3)) level below 50 nmol/L. They received either 1200 mg calcium plus 800 IU vitamin D-3 or 1200 mg calcium/day. We measured intact PTH, 250KD(3), 1,25-dihydroxyvitamin D-3, blood pressure, and heart rate before and after treatment. Compared with calcium, supplementation with vitamin D-3 and calcium resulted in an increase in serum 250HD(3) of 72% (P < 0.01), a decrease in serum PTH of 17% (P = 0.04), a decrease in systolic blood pressure (SBP) of 9.3% (P = 0.02), and a decrease in heart rate of 5.4% (P = 0.02). Sixty subjects (81%) in the vitamin D-3 and calcium group compared with 35 (47%) subjects in the calcium group showed a decrease in SEP of 5 mm Hg or more (P = 0.04). No statistically significant difference was observed in the diastolic blood pressures of the calcium-treated and calcium- plus vitamin D-3-treated groups (P = 0.10). Pearson coefficients of correlation between the change in PTH and the change in SEP were 0.49 (P < 0.01) for the vitamin D-3 plus calcium group and 0.23 (P < 0.01) for the calcium group. A short-term supplementation with vitamin D-3 and calcium is more effective in reducing SEP than calcium alone. Inadequate vitamin D-3 and calcium intake could play a contributory role in the pathogenesis and progression of hypertension and cardiovascular disease in elderly women.
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