Kunutsor Setor K, Laukkanen Jari A
1 School of Clinical Sciences, University of Bristol, UK.
2 Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland.
Eur J Prev Cardiol. 2017 Feb;24(3):239-243. doi: 10.1177/2047487316681174. Epub 2016 Nov 25.
Purpose Calcium, which is one the most abundant mineral elements in the body, has been suggested to be involved in blood pressure regulation. We aimed to assess the association of active serum calcium (which is the ionised and physiologically active form of serum calcium) with the future risk of hypertension. Methods The active serum calcium concentration was assessed at baseline in the Finnish Kuopio Ischemic Heart Disease population-based prospective cohort study of 1562 normotensive men aged 42-61 years at baseline. Cox proportional hazard models were used to assess the hazard ratios (95% confidence intervals (CIs)) for incident hypertension. Results During a median follow-up of 24.9 years, 247 men developed new-onset hypertension. Active serum calcium was inversely associated with incident hypertension in an approximately linear fashion. In age-adjusted analysis, the hazard ratio for hypertension per 1 standard deviation increase in active serum calcium was 0.86 (95% CI 0.76-0.98), which remained consistent after adjustment for several established risk factors and potential confounders 0.82 (0.71-0.94). In a comparison of extreme quintiles of active serum calcium levels, the corresponding adjusted hazard ratios were 0.59 (95% CI 0.39-0.90) and 0.54 (95% CI 0.35-0.82), respectively. Conclusion Active serum calcium is protective of future hypertension in a middle-aged male Caucasian population. Further research is needed to confirm these findings and help unravel the mechanistic pathways of calcium in the pathogenesis of hypertension.
目的 钙是人体中含量最丰富的矿物质元素之一,有人认为它与血压调节有关。我们旨在评估活性血清钙(即血清钙的离子化且具有生理活性的形式)与未来患高血压风险之间的关联。方法 在芬兰库奥皮奥缺血性心脏病基于人群的前瞻性队列研究中,对1562名基线时血压正常、年龄在42 - 61岁的男性进行了基线时活性血清钙浓度评估。采用Cox比例风险模型评估高血压发病的风险比(95%置信区间(CI))。结果 在中位随访24.9年期间,247名男性出现了新发高血压。活性血清钙与高血压发病呈近似线性的负相关。在年龄调整分析中,活性血清钙每增加1个标准差,高血压的风险比为0.86(95%CI 0.76 - 0.98),在调整了多个已确定的风险因素和潜在混杂因素后,该比值仍保持一致,为0.82(0.71 - 0.94)。在活性血清钙水平的极端五分位数比较中,相应的调整后风险比分别为0.59(95%CI 0.39 - 0.90)和0.54(95%CI 0.35 - 0.82)。结论 活性血清钙对中年男性白种人群未来患高血压具有保护作用。需要进一步研究来证实这些发现,并有助于阐明钙在高血压发病机制中的作用途径。