Abstract
Increasing evidence indicates that high blood pressure is associated with abnormalities in calcium metabolism. Sustained calcium loss may lead to increased bone-mineral loss in subjects with elevated blood pressure. Furthermore, recent findings indicate a possible linkage between abnormal calcium metabolism and insulin resistance. In the present study, we investigated the relationship(s) among bone-mineral density (BMD), blood pressure, calcium-related and bone metabolic parameters (plasma intact parathyroid hormone (I-PTH), 1,25-dihydroxyvitamin D [1,25(OH)2D], osteocalcin, and urinary deoxypyridinoline), and insulin resistance, as assessed by a conventional homeostasis model (HOMA-R). We compared non-diabetic women with essential hypertension (WHT, n=34) with age-, body mass index- and menopause (yes or no)-matched normotensive, non-diabetic women (WNT, n=34). The BMD for WHT was significantly lower than that for WNT (0.596±0.019 vs. 0.666 ±0.024 g/cm2, p<0.05). The BMD was correlated inversely with systolic blood pressure in all subjects examined (r=-0.385, p<0.05). The 24-h urinary calcium/sodium excretion ratio (Ux-Ca/Na) was significantly greater in WHT compared with WNT (p<0.01). In addition, a negative relationship was apparent between Ux-Ca/Na and BMD (r=-0.58, p<0.05). The plasma levels of PTH and 1,25(OH)2D, and HOMA-R were significantly higher in WHT compared with WNT (p<0.01, p<0.05, and p<0.05, respectively), whereas the serum ionized calcium was lower in WHT compared with WNT (p<0.05). There were no significant differences in serum total calcium, inorganic phosphorus, osteocalcin, or urinary deoxypyridinoline between the two groups. These results indicate that high blood pressure is associated with abnormalities in calcium metabolism and insulin resistance in WHT.
Similar content being viewed by others
Article PDF
References
McCarron DA, Pingree PA, Pingree PA, et al: Enhanced parathyroid function in essential hypertension: a homeostatic response to a urinary calcium leak. Hypetension 1980; 2: 162–168.
Strazzullo P, Nunziata M, Cirillo M, et al: Abnormalities of calcium metabolism in essential hypertension. Clin Sci 1983; 65: 137–141.
Hvarfner A, Bergström R, Mörlin C, Wide L, Ljunghall : Relationships between calcium metabolic indices and blood pressure in patients with essential hypertension as compared with a healthy population. J Hypertens 1987; 5: 451–456.
Grobbee DE, Hackeng WHL, Birkenhäger JC, Hofmann A : Raised plasma intact parathyroid hormone concentrations in young people with mildly raised blood pressure. BMJ 1988; 296: 814–816.
Brickman AS, Nyby MD, von Hungen K, Eggena P, Tuck ML : Calcitropic hormones, platelet calcium, and blood pressure in essential hypertension. Hypertension 1990; 16: 515–522.
Gadallah M, Massry SG, Bigazzi R, Horst RL, Eggena P, Campese VM : Intestinal absorption of calcium and calcium metabolism in patients with essential hypertension and normal renal function. Am J Hypertens 1991; 4: 404–409.
Young EW, Morris CD, McCarron DA : Urinary calcium excretion in essential hypertension. J Lab Clin Med 1992; 120: 624–632.
Cappuccio FP, Meilahn E, Zmuda JM, Cauley JA : High blood pressure and bone-mineral loss in elderly white women: a prospective study. Lancet 1999; 354: 971–975.
Cutler JA, Brittain E : Calcium and blood pressure: an epidemiologic perspective. Am J Hypertens 1990; 3: S137–S146.
Sacks FM, Brown LE, Appel L, Borhani NO, Evans D, Whelton P : Combinations of potassium, calcium, and magnesium supplements in hypertension. Hypertension 1995; 26: 950–956.
Belizan JM, Villar J, Gonzales L, Campodonico L, Bergel E : Calcium supplementation to prevent hypertensive disorders of pregnancy. N Engl J Med 1991; 325: 1399–1405.
Young EW, McCarron DA, Morris CD : Calcium regulating hormones in essential hypertension: importance of gender. Am J Hypertens 1990; 3: S161–S166.
DeFronzo RA, Cooke CR, Andres R, Faloona GR, Davis PJ : The effect of insulin on renal handling of sodium, potassium, calcium, and phosphate in man. J Clin Invest 1975; 55: 845–855.
DeFronzo RA, Goldberg M, Agus ZS : The effect of glucose and insulin on renal electrolyte transport. J Clin Invest 1976; 58: 83–90.
Shimamoto K, Higashiura K, Nakagawa M, et al: Effects of hyperinsulinemia under the euglycemic condition on calcium and phosphate metabolism in non-obese normotensive subjects. Tohoku J Exp Med 1995; 177: 271–278.
Ohno Y, Suzuki H, Yamakawa H, Nakamura M, Saruta T : Insulin sensitivity and calcium homeostasis in young, lean, normotensive male subjects. Hypertens Res 2000; 23: 433–440.
Seino Y, Ishida H : Diabetic osteopenia: pathophysiology and clinical aspects. Diabetes Metab Rev 1995; 11: 21–35.
Wakasugi M, Wakao R, Tawata M, Gan N, Koizumi K, Onaya T : Bone mineral density measured by dual energy x-ray absorptiometry in patients with non-insulin-dependent diabetes mellitus. Bone 1993; 14: 29–33.
Joint National Committee on Prevention, Detection, Evaluation, and the Treatment of High Blood Pressure : The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997; 157: 2413–2446.
The Expert Committee on the Diagnosis and Classification on Diabetes Mellitus : Report of the expert committee on diagnosis and classification of diabetes mellitus. Diabetes Care 1997; 20: 1183–1197.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC : Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–419.
Grobbee DE, Burger H, Hofman A, Pols HA : Blood pressure and bone mineral density are inversely related in the elderly. J Hypertens 1996; 14 ( Suppl 1): S35 ( Abstract).
Hughes GSJ, Oexmann MJ, Margolius HS, Epstein S, Bell NH : Normal vitamin D and mineral metabolism in essential hypertension. Am J Med Sci 1988; 296: 252–259.
Tillman DM, Semple PF : Calcium and magnesium in essential hypertension. Clin Sci 1988; 75: 395–402.
Canaff L, Hendy GN : Human calcium-sensing receptor gene. J Biol Chem 2002; 277: 30337–30350.
McCarron DA : Low serum concentrations of ionized calcium in patients with hypertension. N Engl J Med 1982; 307: 226–228.
Pang PKT, Tenner TEJ, Yee JA, Yang M, Janssen HF : Hypotensive action of parathyroid hormone preparations on rats and dogs. Proc Natl Acad Sci U S A 1980; 77: 675–678.
Nickols GA, Cline WHJ : Parathyroid hormone-induced changes in cyclic nucleotide levels during relaxation of the rat aorta. Life Sci 1987; 40: 2351–2359.
Gairard A, Berthelot A, Schleiffer R, Pernot F : Parathyroidectomy significantly decreases hypertension in spontaneously hypertensive and deoxycortisone plus saline treated rats. Can J Physiol Pharmacol 1982; 60: 208–212.
Rosenthal FD, Roy S : Hypertension and hyperthyroidism. Br Med J 1972; 4: 396–397.
Walters MR, Wicker DC, Riggle PC : 1,25-Dihydroxyvitamin D3 receptors identified in the rat heart. J Mol Cell Cardiol 1986; 18: 67–72.
Kawashima H : Receptor for 1,25-hydroxyvitamin D in a vascular smooth muscle cell line derived from rat aorta. Biochem Biophys Res Commun 1987; 146: 1–6.
Merke J, Habenicht A, Goldschmidt D, Ritz E : Evidence for 1,25(OH)2D3 receptors in bovine aortic endothelial cells. J Bone Miner Res 1986; 1 ( Suppl 1): A398 ( Abstract).
Bukoski RD, Xue H, McCarron DA : Effect of 1,25(OH)2 vitamin D3 and ionized Ca2+ on 45Ca uptake by primary cultures of aortic myocytes of spontaneously hypertensive and Wistar Kyoto normotensive rats. Biochem Biophys Res Commun 1987; 146: 1330–1335.
Kawashima K : 1,25-Dihydroxyvitamin D3 stimulates Ca-ATPase in a vascular smooth muscle cell line. Biochem Biophys Res Commun 1988; 150: 1138–1143.
Koh E, Morimoto S, Fukuo K, et al: 1,25-Dihydroxyvitamin D3 binds specifically to rat vascular smooth muscle cells and stimulates their proliferation in vitro. Life Sci 1988; 42: 215–223.
Resnick LM, Laragh JH : Short-term effects of 1,25-dihydroxy vitamin D3 on blood pressure in essential hypertension. Kidney Int 1984; 26: 206 ( Abstract).
Bukoski RD, DeWan P, Hatton DC, McCarron DA : 1,25(OH)2 vitamin D3 differentially modulates vascular Ca2+ metabolism in hypertensive (SHR) and normotensive rats (WKY). Hypertension 1988; 12: 361 ( Abstract).
van Hooft IMS, Grobbee DE, Frölich M, pols HAP, Hofman A : Alternations in calcium metabolism in young people at risk for primary hypertension: the Dutch hypertension and offspring study. Hypertension 1993; 21: 267–272.
D'Erasmo E, Pisani D, Ragno A, Raejntroph N, Vecci E, Acca M : Calcium homeostasis during oral glucose load in healthy women. Horm Metab Res 1999; 31: 271–273.
Draznin B : Cytosolic calcium and insulin resistance. Am J Kidney Dis 1993; 21 ( Suppl 3): 32–38.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Gotoh, M., Mizuno, K., Ono, Y. et al. High Blood Pressure, Bone-Mineral Loss and Insulin Resistance in Women. Hypertens Res 28, 565–570 (2005). https://doi.org/10.1291/hypres.28.565
Received:
Accepted:
Issue date:
DOI: https://doi.org/10.1291/hypres.28.565
Keywords
This article is cited by
-
Non-linear relationship between pulse pressure and the risk of prediabetes: a 5-year cohort study in Chinese adults
Scientific Reports (2024)
-
Effect of Primary Hypertension on Treatment Outcomes of Patients with Postmenopausal Osteoporosis: A 5 Year Follow Up Retrospective Study
High Blood Pressure & Cardiovascular Prevention (2019)
-
Control of Bone Remodeling by the Peripheral Sympathetic Nervous System
Calcified Tissue International (2014)
-
Association between metabolic syndrome and bone mineral density in Korea: the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV), 2008
Journal of Bone and Mineral Metabolism (2013)
-
Use of β-Blockers and the Risk of Hip/Femur Fracture in the United Kingdom and The Netherlands
Calcified Tissue International (2007)
