Meese R B, Gonzales D G, Casparian J M, Ram C V, Pak C M, Kaplan N M
Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas 75235-9030.
Am J Med Sci. 1987 Oct;294(4):219-24. doi: 10.1097/00000441-198710000-00001.
The effects of 800 mg of elemental calcium per day (calcium carbonate or calcium citrate) on blood pressure were compared with a placebo in a controlled randomized, crossover, double-blinded trial involving 26 patients with uncomplicated primary hypertension. Each patient took two of the three forms of therapy orally for 8-week intervals with a 2-week washout period in between. Standing mean blood pressure rose an average of 5.7 mm Hg on placebo, rose an average of 0.5 mm Hg on calcium carbonate, and fell an average of 2.2 mm Hg on calcium citrate. Changes in sitting mean pressures averaged +1.9 mm Hg on placebo, -0.4 mm Hg on calcium carbonate, and -0.4 mm Hg on calcium citrate. Some patients had a fall, others had a rise in blood pressure on each form of calcium. Similarly, inconsistent responses were noted among the nine patients who took both forms of calcium. Neither initial nor post-treatment biochemical measures nor patient characteristics were predictive of the blood pressure response. Combinations of various measures and characteristics analyzed by the multiple regression technique explained only 30% of the overall variability in blood pressure. Therefore, until ways can be found to predict the response, calcium supplements should not be routinely prescribed for the treatment of hypertension and, if given for any indication, blood pressure should be monitored.
在一项涉及26例无并发症原发性高血压患者的对照随机、交叉、双盲试验中，比较了每天800毫克元素钙（碳酸钙或枸橼酸钙）与安慰剂对血压的影响。每位患者口服三种治疗方式中的两种，每种持续8周，中间有2周的洗脱期。安慰剂组站立平均血压平均升高5.7毫米汞柱，碳酸钙组平均升高0.5毫米汞柱，枸橼酸钙组平均降低2.2毫米汞柱。坐位平均血压变化在安慰剂组平均为+1.9毫米汞柱，碳酸钙组为-0.4毫米汞柱，枸橼酸钙组为-0.4毫米汞柱。在每种钙治疗方式下，一些患者血压下降，另一些患者血压上升。同样，在服用两种钙的9名患者中也观察到了不一致的反应。治疗前和治疗后的生化指标以及患者特征均无法预测血压反应。通过多元回归技术分析的各种指标和特征的组合仅解释了血压总体变异性的30%。因此，在找到预测反应的方法之前，不应常规开钙补充剂用于治疗高血压，如果出于任何适应症给予钙补充剂，应监测血压。
