Dietary calcium and blood pressure: a meta-analysis of randomized clinical trials.
OBJECTIVE
To assess the effect of dietary calcium supplementation on blood pressure.


METHODS
Published reports of trials studying the effect of dietary calcium supplementation on blood pressure were identified by a search of previous reviews, a MEDLINE search, a manual review of journal articles, and a review of abstracts from scientific meetings.


METHODS
Randomized clinical trials in which dietary calcium intake varied by intervention group were selected. Multifactorial trials were not included.


RESULTS
Data from 28 active treatment arms or strata from 22 randomized clinical trials were pooled using a weighted average method, with weights proportional to the inverse of the variance of the treatment effect. The total sample comprised 1231 persons. Because trials of both normotensive and hypertensive persons were included, subgroup analyses could be done. Pooled estimates of the effect of calcium supplementation on blood pressure were -0.18 mm Hg for diastolic blood pressure (95% CI, -0.75 to 0.40 mm Hg) and -0.89 mm Hg for systolic blood pressure (CI, -1.74 to -0.05 mm Hg). Pooled estimates for systolic blood pressure were -0.53 mm Hg (CI, -1.56 to 0.49 mm Hg) for trials of normotensive persons and -1.68 mm Hg (CI, -3.18 to -0.18 mm Hg) for trials of hypertensive persons. Diastolic blood pressure was not significantly affected in either subgroup.


CONCLUSIONS
The pooled estimate shows a statistically significant decrease of systolic blood pressure with calcium supplementation, both for hypertensive persons and for the overall sample. However, the effect is too small to support the use of calcium supplementation for preventing or treating hypertension.
Allender
P S
PS
Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, Bethesda, MD 20892 USA.
Cutler
J A
JA
Follmann
D
D
Cappuccio
F P
FP
Pryer
J
J
Elliott
P
P
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D002136:Calcium, Dietary / Q000494:pharmacology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
D002136:Calcium, Dietary