Document Type : Original Article


Food Security Research Center and Department of Clinical Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran


Introduction: Cardiovascular disease is the major cause of mortality in developed countries and has
an increasing trend in developing countries. There are some evidences that calcium supplementation
may decrease blood pressure and consequently cardiovascular disease, but they are not conclusive
and there is no agreement in this respect. The aim of the present study was to assess the effect
of supplementary calcium on systolic and diastolic blood pressure in healthy adult women aged
18–30 years. Materials and Methods: Seventy‑five normotensive volunteers were randomly divided
into two groups, the treatment group received 1000 mg/day calcium (four doses of 625 mg calcium
carbonate) for 1 month and the control group received placebo (dextrose). Systolic and diastolic
blood pressure was determined before and after intervention in supine position after 10 min of rest.
Results: The mean daily calcium intake from food was 773.9 mg in treatment and 721 mg in control
group (no significant difference) but in both the groups dietary calcium intake was less than the
recommended dietary allowance: After calcium supplementation, the mean change of systolic blood
pressure was not significant in the two groups, but diastolic blood pressure reduced in treatment
group and increased in control group (−4.9 vs 2.6 mmHg) (P < 0.05). Conclusions: These results
suggest that, calcium supplementation does not have any effect on systolic blood pressure of our
volunteers but can decrease diastolic blood pressure significantly and therefore it seems that calcium
supplementation may be useful for people with increased diastolic blood pressure, especially for
those who receive less calcium than recommended dietary allowance.


1. Azizi F, Ghanbarian A, Majidi M, Rahmani M. Distribution of blood
pressure and prevalence of hypertension in Tehran adult population:
Tehran lipid and glucose study, 1999‑2000. J Hum Hypertens
2. Sarrafzadegan N, Talaei M, Sadeghi M, Kelishadi R, Oveisgharan S,
Mohammadifard N, et al. The Isfahan cohort study: Rationale,
methods and main findings. J Hum Hypertens 2011;25:545‑53.
3. Malekzadeh MM, Etemadi A, Kamangar F, Khademi H, Golozar A,
Islami F, et al. Prevalence, awareness and risk factors of
hypertension in a large cohort of Iranian adult population.
J Hypertens 2013;31:1364‑71.
4. Umesawa M, Iso H, Ishihara J, Saito I, Kokubo Y, Inoue M, et al.
Dietary calcium intake and risks of stroke, its subtypes and coronary
heart disease in Japanese: The JPHC Study Cohort I. Stroke
5. Iso H, Stampfer MJ, Manson JE, Rexrode K, Hennekens CH,
Colditz JA, et al. Prospective study of calcium, potassium
and magnesium intake and risk of stroke in women. Stroke
6. Abbott RD, Curb JD, Rodriguez BL, Sharp DS, Burchfiel CM,
Yano K. Effect of dietary calcium and milk consumption on risk of
thromboembolic stroke in older middle‑aged men. The Honolulu
Heart Program. Stroke 1996;27:813‑8.
7. Wang L, Manson JE, Buring JE, Lee IM, Sesso HD. Dietary intake of
dairy products, calcium, and vitamin D and the risk of hypertension
in middle‑aged and older women. Hypertension 2008;5:1073‑9.
8. Khatake PD, Jadhav SS, Afroz S. Relation between Serum Calcium
Level, Bone mineral density and blood pressure in postmenopausal
women. Int J Recent Trends Sci Tech 2013;7:86‑8.
9. Al‑Delaimy WK, Rimm E, Willett WC, Stampfer MJ, Hu FB.
A prospective study of calcium intake from diet and supplements
and risk of ischemic heart disease among men. Am J Clin Nutr
10. Marniemi J, Alanen E, Impivaara O, Seppänen R, Hakala P, Rajala T,
et al. Dietary and serum vitamins and minerals as predictors of
myocardial infarction and stroke in elderly subjects. Nutr Metab
Cardiovasc Dis 2005;15:188‑97.
11. Ascherio A, Rimm EB, Hernan MA, Giovannucci EL, Kawachi I,
Stampfer MJ, et al. Intake of potassium, magnesium, calcium
and fiber and risk of stroke among US men. Circulation
12. Larsson SC, Virtanen MJ, Mars M, Männistö S, Pietinen P, Albanes D,
et al. Magnesium, calcium, potassium and sodium intakes and risk
of stroke in male smokers. Arch Intern Med 2008;168:459‑65.
13. Umesawa M, Iso H, Date C, Yamamoto A, Toyoshima H,
Watanabe Y, et al. Dietary intake of calcium in relation to mortality
from cardiovascular disease: The JACC Study. Stroke 2006;37:20‑6.
14. Ross RK, Yuan JM, Henderson BE, Park J, Gao YT, Yu MC.
Prospective evaluation of dietary and other predictors of fatal stroke
in Shanghai, China. Circulation 1997;96:50‑5.
15. Van der Vijver LP, van der Waal MA, Weterings KG, Dekker JM,
Schouten EG, Kok FJ. Calcium intake and 28‑year cardiovascular
and coronary heart disease mortality in Dutch civil servants. Int J
Epidemiol 1992;21:36‑9.
16. Larsson SC, Virtamo J, Wolk A. Potassium, calcium and magnesium
intakes and risk of stroke in women. Am J Epidemiol 2011;174:35‑43.
17. Bolland MJ, Grey A, Gamble GD, Reid IR. Calcium and vitamin D
supplements and health outcomes: A reanalysis of the Women’s
Health Initiative (WHI) limited‑access data set. Am J Clin Nutr
18. Bolland MJ, Barber PA, Doughty RN, Mason B, Horne A, Ames R,
et al. Effect of calcium supplements on risk of myocardial infarction
and cardiovascular events: Meta‑analysis. BMJ 2010;341:c3691.
19. McGarvey ST, Zinner SH, Willett WC, Rosner B. Maternal prenatal
dietary potassium, calcium, magnesium, and infant blood pressure.
Hypertension 1991;17:218‑24.
20. Gillman MW, Rifas‑Shiman SL, Kleinman KP, Rich‑Edwards JW,
Lipshultz SE. Maternal calcium intake and offspring blood pressure.
Circulation 2004;110:1990‑5.
21. Hawkesworth S, Sawo Y, Fulford AJ, Goldberg GR, Jarjou LM,
Prentice A, et al. Effect of maternal calcium supplementation on
offspring blood pressure in 5‑ to 10‑y‑old rural Gambian children.
Am J Clin Nutr 2010;92:741‑7.
22. Shidfar F, Moghayedi M, Reza S, Kerman J, Hosseini S,
Shidfar S. Effects of a calcium supplement on serum lipoproteins,
polipoprotein B, and blood pressure in overweight men. Int J
Endocrinol Metab 2010;8:194‑200.
23. Salem Z, Omidvar N, Mahmudi M, Ovladi B. The effects of
supplementary calcium on blood pressure of pregnant women.
Journal of Shahid Beheshti University of Medical Sciences Research
24. Ostadrahimi AR, Mahboob S, Afiatmilani SH. Relationship between
blood pressure and daily sodium, potassium, calcium intake and
BMI. J Qazvin Univ Med Sci 2003;26:36‑40.
25. Houston MC, Harper KJ, Potassium, Magnesium, and Calcium:Their Role in Both the Cause and Treatment of Hypertension. J Clin
Hypertens 2008;10(Suppl 2):3‑11.
26. Appel LJ, Moore TJ, Obarzanek E, Vollmer WM, Svetkey LP,
Sacks FM, et al. A clinical trial of the effects of dietary patterns on
blood pressure. Research Group. N Engl J Med 2004;336:1117‑24.
27. Jorde R, Sundsfjord J, Haug E, Bonaa KH. Relation between
low calcium intake, parathyroid hormone, and blood pressure.
Hypertension 2000;35:1154‑9.
28. Smajilovic S, Tfelt‑Hansen J. Novel role of the calcium‑sensing
receptor in blood pressure modulation. Hypertension
29. Tfelt‑Hansen J, Brown EM. The calcium‑sensing receptor in normal
physiology and pathophysiology: A review. Crit Rev Clin Lab Sci
30. Resnick L. The cellular ionic basis of hypertension and allied clinical
conditions. Progr Cardiovasc Dis 2005;42:1‑22.
31. Yoon JS, Lee MJ. Calcium Status and Bone Mineral Density by the
Level of Sodium Intake in Young Women. Korean J Community
Nutr 2013;18:125‑33.
32. Zemel MB, Gualdoni SM, Sowers JR. Reductions in total and
extracellular water associated with calcium‑induced natriuresis and
the antihypertensive effect of calcium in blacks. Am J Hypertens
33. Zemel MB, Kraniak J, Standley PR, Sowers JR. Erythrocyte cation
metabolism in salt‑sensitive blacks as affected by dietary sodium
and calcium. Am J Hypertens 1988;1:386‑92.
34. Sheikholeslam R. Micronutrients and methods to prevent their
deficiencies based on based on food supplementation. 1st ed. Iran:
Ministry of Health and medical education; 2007.
35. Ackley S, Connor EB, Suarez L. Dairy products, calcium, and blood
pressure. Am J Clin Nutr 1983;38:457‑61.
36. Park J, Lee GS, Kim J. Relationship between dietary sodium,
potassium, and calcium, anthropometric indexes, and blood
pressure in young and middle aged Korean adults. Nutr Res Pract
37. Khatake PD, Jadhav SS, Afroz S. Relation between Serum Calcium
Level, Bone Mineral Density and Blood Pressure in Postmenopausal
Women. Int J Recent Trends Sci Tech 2013;7:86‑8.