Pfeifer M, Begerow B, Minne H W, Nachtigall D, Hansen C
Institute of Clinical Osteology Gustav Pommer, Clinic der Fürstenhof, 31812 Bad Pyrmont, Germany.
J Clin Endocrinol Metab. 2001 Apr;86(4):1633-7. doi: 10.1210/jcem.86.4.7393.
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 (25OHD(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, 25OHD(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 25OHD(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 SBP 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 SBP 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 SBP 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.
补钙在降低各种高血压状态下的血压方面是有效的，包括妊娠高血压和先兆子痫。此外，钙调节激素与血压有关。研究假设是，与单纯补钙相比，短期补充钙和维生素D(3)可能更有效地改善血压以及继发性甲状旁腺功能亢进。研究了补充维生素D(3)（胆钙化醇）和钙8周对血压及骨代谢生化指标的影响。样本包括148名25-羟胆钙化醇（25OHD(3)）水平低于50 nmol/L的女性（平均±标准差年龄，74±1岁）。她们分别接受1200 mg钙加800 IU维生素D(3)或1200 mg钙/天的治疗。我们在治疗前后测量了完整甲状旁腺激素（PTH）、25OHD(3)、1,25-二羟维生素D(3)、血压和心率。与单纯补钙相比，补充维生素D(3)和钙使血清25OHD(3)升高72%（P<0.01），血清PTH降低17%（P = 0.04），收缩压（SBP）降低9.3%（P = 0.02），心率降低5.4%（P = 0.02）。维生素D(3)和钙组60名受试者（81%）与钙组35名受试者（47%）相比，SBP降低了5 mmHg或更多（P = 0.04）。钙治疗组和钙加维生素D(3)治疗组的舒张压未观察到统计学显著差异（P = 0.10）。维生素D(3)加钙组PTH变化与SBP变化之间的Pearson相关系数为0.49（P<0.01），钙组为0.23（P<0.01）。短期补充维生素D(3)和钙在降低SBP方面比单纯补钙更有效。维生素D(3)和钙摄入不足可能在老年女性高血压和心血管疾病的发病机制及进展中起促成作用。
