The effect of calcium supplementation on blood pressure in non-pregnant women with previous pre-eclampsia: An exploratory,randomized placebo controlled study |
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| Affiliation: | 1. Department of Obstetrics and Gynaecology, East London Hospital Complex, University of the Witwatersrand, South Africa;2. University of Fort Hare, Eastern Cape Department of Health, East London, South Africa;3. Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland;4. World Health Organization Regional Office for Europe, Marmorvej 51, Copenhagen, Denmark;5. Institute for Clinical Effectiveness and Health Policy (IECS), Emilio Ravignani 2024, Buenos Aires, Argentina;6. University of Zimbabwe, Harare, Zimbabwe;7. Department of Nursing Sciences, Fort Hare University, South Africa;8. Department of Obstetrics and Gynaecology, University of Cape Town, South Africa;9. Head, Obstetric Services, Mowbray Maternity Hospital, Cape Town, South Africa;10. Department of Obstetrics and Gynaecology, University of the Witwatersrand, South Africa;11. Department of Obstetrics and Gynaecology, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa;12. Magee-Womens Research Institute, Department of Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, USA;13. Department of Obstetrics and Gynaecology, University of British Columbia, Room V3-339, 950 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada;1. National Resource Center for Women’s Health, Oslo University Hospital Rikshospitalet, Oslo, Norway;2. Department of Cardiology, Oslo University Hospital Rikshospitalet, Oslo, Norway;3. Department of Anaesthesiology, Oslo University Hospital Rikshospitalet, Oslo, Norway;4. Institute for Surgical Research, Oslo University Hospital Rikshospitalet, Oslo, Norway;5. Section of Specialized Endocrinology, Oslo University Hospital Rikshospitalet, Oslo, Norway;6. Department of Obstetrics, Oslo University Hospital Rikshospitalet, Oslo, Norway;7. Research Institute for Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway;8. Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital Rikshospitalet, Oslo, Norway;9. Faculty of Medicine, University of Oslo, Oslo, Norway;10. K.G. Jebsen Inflammatory Research Center, University of Oslo, Oslo, Norway;11. K.G. Jebsen Cardiac Research Center and Center for Heart Failure Research, University of Oslo, Oslo, Norway;1. University of Vermont, Department of Obstetrics, Gynecology and Reproductive Sciences, Burlington, VT 05405, United States;2. University of Vermont, Department of Medical Biostatistics, Burlington, VT 05405, United States;3. University of Vermont, Department of Pediatrics, Burlington, VT 05405, United States;4. Vermont Oxford Network, Burlington, VT 05401, United States;1. Department of Maternity Services, Royal Women’s Hospital, Cnr Flemington Rd and Grattan St, Parkville 3053, Australia;2. Department of Statistical Risk Management, KPMG, 147 Collins St, Melbourne 3000, Australia;3. Department of Obstetrics and Gynecology, University of Melbourne, Australia;1. Department of Obstetrics and Gynecology, Rowan University – School of Osteopathic Medicine, Stratford, NJ, United States;2. Department of Obstetrics and Gynecology, Yale University – School of Medicine, OB/GYN, New Haven, CT, United States;3. Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States;1. Department of Obstetrics & Gynecology, Affiliated Hospital, Logistical College of Chinese People’s Armed Police Forces, Tianjin 300162, PR China;2. Maternity & Children Hospital of Northwest District, Shaanxi, Xi’an 710003, PR China;3. Department of Obstetrics & Gynecology, Xijing Hospital, Fourth Military Medical University, Shaanxi, Xi’an 710033, PR China |
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| Abstract: | ![]()
BackgroundEpidemiological findings suggest that the link between poverty and pre-eclampsia might be dietary calcium deficiency. Calcium supplementation has been associated with a modest reduction in pre-eclampsia, and also in blood pressure (BP).MethodsThis exploratory sub-study of the WHO Calcium and Pre-eclampsia (CAP) trial aims to determine the effect of 500 mg/day elemental calcium on the blood pressure of non-pregnant women with previous pre-eclampsia. Non-pregnant women with at least one subsequent follow-up trial visit at approximately 12 or 24 weeks after randomization were included.ResultsOf 836 women randomized by 9 September 2014, 1st visit data were available in 367 women of whom 217 had previously had severe pre-eclampsia, 2nd visit data were available in 201 women. There was an overall trend to reduced BP in the calcium supplementation group (1–2.5 mmHg) although differences were small and not statistically significant. In the subgroup with previous severe pre-eclampsia, the mean diastolic BP change in the calcium group (−2.6 mmHg) was statistically larger than in the placebo group (+0.8 mmHg), (mean difference −3.4, 95% CI −0.4 to −6.4; p = 0.025). The effect of calcium on diastolic BP at 12 weeks was greater than in those with non-severe pre-eclampsia (p = 0.020, ANOVA analysis).ConclusionsThere is an overall trend to reduced BP but only statistically significant in the diastolic BP of women with previous severe pre-eclampsia. This is consistent with our hypothesis that this group is more sensitive to calcium supplementation, however results need to be interpreted with caution. |
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| Keywords: | Hypertension Calcium Blood Pressure Supplementation Preeclampsia |
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