Low Calcium Intake in Midpregnancy Is Associated with Hypertension Development within 10 Years after Pregnancy: The Norwegian Mother and Child Cohort Study
Low dietary calcium intake may be a risk factor for hypertension, but studies conflict. We evaluated the ability to predict hypertension within 10 y after delivery based on calcium intake during midpregnancy. The Norwegian Mother and Child Cohort Study of women delivering in 2004-2009 was linked to...
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| Veröffentlicht in: | The Journal of nutrition 2017-09, Vol.147 (9), p.1757-1763 |
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| creator | Egeland, Grace M Skurtveit, Svetlana Sakshaug, Solveig Daltveit, Anne Kjersti Vikse, Bjørn E Haugen, Margaretha |
| description | Low dietary calcium intake may be a risk factor for hypertension, but studies conflict.
We evaluated the ability to predict hypertension within 10 y after delivery based on calcium intake during midpregnancy.
The Norwegian Mother and Child Cohort Study of women delivering in 2004-2009 was linked to the Norwegian Prescription Database (2004-2013) to ascertain antihypertensive medication usage >90 d after delivery. Women with hypertension before pregnancy were excluded, leaving 60,027 mothers for analyses. Age and energy-adjusted cubic splines evaluated dose-response curves, and Cox proportional hazard analyses evaluated HR and 95% CIs by calcium quartiles adjusting for 7 covariates. Analyses were stratified by gestational hypertension and by sodium-to-potassium intake ratio ( |
| doi_str_mv | 10.3945/jn.117.251520 |
| format | Article |
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We evaluated the ability to predict hypertension within 10 y after delivery based on calcium intake during midpregnancy.
The Norwegian Mother and Child Cohort Study of women delivering in 2004-2009 was linked to the Norwegian Prescription Database (2004-2013) to ascertain antihypertensive medication usage >90 d after delivery. Women with hypertension before pregnancy were excluded, leaving 60,027 mothers for analyses. Age and energy-adjusted cubic splines evaluated dose-response curves, and Cox proportional hazard analyses evaluated HR and 95% CIs by calcium quartiles adjusting for 7 covariates. Analyses were stratified by gestational hypertension and by sodium-to-potassium intake ratio (<0.76 compared with ≥0.76).
Participants had a mean ± SD age of 30.5 ± 4.6 y, a body mass index (in kg/m2) of 24.0 ± 4.3 before pregnancy, and a mean follow-up duration of 7.1 ± 1.6 y. Cubic spline graphs identified a threshold effect of low calcium intake only within the range of dietary inadequacy related to increased risk. The lowest calcium quartile (≤738 mg/d; median: 588 mg/d), relative to the highest quartile (≥1254 mg/d), had an HR for hypertension of 1.34 (95% CI: 1.05, 1.70) among women who were normotensive during pregnancy, and an HR of 1.62 (95% CI: 1.14, 2.35) among women who had gestational hypertension, after adjusting for covariates. Women with gestational hypertension, who were in the lowest quartile of calcium intake, and who had a high sodium-to-potassium intake ratio had a risk of hypertension more than double that of their counterparts with a calcium intake in the highest quartile. Results were attenuated by adjusting for covariates (HR: 1.92; 95% CI: 1.09, 3.39).
The results suggest that low dietary calcium intake may be a risk factor or risk marker for the development of hypertension, particularly for women with a history of gestational hypertension.</description><identifier>ISSN: 0022-3166</identifier><identifier>EISSN: 1541-6100</identifier><identifier>DOI: 10.3945/jn.117.251520</identifier><identifier>PMID: 28701386</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Antihypertensives ; Body mass ; Body mass index ; Body size ; Calcium ; Calcium (dietary) ; Calcium - administration & dosage ; Calcium - deficiency ; Calcium, Dietary - administration & dosage ; cardiovascular disease ; Cohort analysis ; Cohort Studies ; Deficiency Diseases - complications ; Diet ; Drugs ; Female ; Follow-Up Studies ; gestational hypertension ; Humans ; Hypertension ; Hypertension - etiology ; Hypertension, Pregnancy-Induced ; Norway ; nutrition ; Nutritional Epidemiology ; Potassium ; Potassium - administration & dosage ; preeclampsia ; Pregnancy ; Pregnancy Complications ; Proportional Hazards Models ; Prospective Studies ; Quartiles ; Risk Factors ; Sodium ; Sodium - administration & dosage ; Splines ; Women</subject><ispartof>The Journal of nutrition, 2017-09, Vol.147 (9), p.1757-1763</ispartof><rights>2017 American Society for Nutrition.</rights><rights>Copyright American Institute of Nutrition Sep 1, 2017</rights><rights>2017 American Society for Nutrition 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-d443505c523597cc72f594b8036636c3f9805bafb5aee87cf9533c04b0544acf3</citedby><cites>FETCH-LOGICAL-c463t-d443505c523597cc72f594b8036636c3f9805bafb5aee87cf9533c04b0544acf3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28701386$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Egeland, Grace M</creatorcontrib><creatorcontrib>Skurtveit, Svetlana</creatorcontrib><creatorcontrib>Sakshaug, Solveig</creatorcontrib><creatorcontrib>Daltveit, Anne Kjersti</creatorcontrib><creatorcontrib>Vikse, Bjørn E</creatorcontrib><creatorcontrib>Haugen, Margaretha</creatorcontrib><title>Low Calcium Intake in Midpregnancy Is Associated with Hypertension Development within 10 Years after Pregnancy: The Norwegian Mother and Child Cohort Study</title><title>The Journal of nutrition</title><addtitle>J Nutr</addtitle><description>Low dietary calcium intake may be a risk factor for hypertension, but studies conflict.
We evaluated the ability to predict hypertension within 10 y after delivery based on calcium intake during midpregnancy.
The Norwegian Mother and Child Cohort Study of women delivering in 2004-2009 was linked to the Norwegian Prescription Database (2004-2013) to ascertain antihypertensive medication usage >90 d after delivery. Women with hypertension before pregnancy were excluded, leaving 60,027 mothers for analyses. Age and energy-adjusted cubic splines evaluated dose-response curves, and Cox proportional hazard analyses evaluated HR and 95% CIs by calcium quartiles adjusting for 7 covariates. Analyses were stratified by gestational hypertension and by sodium-to-potassium intake ratio (<0.76 compared with ≥0.76).
Participants had a mean ± SD age of 30.5 ± 4.6 y, a body mass index (in kg/m2) of 24.0 ± 4.3 before pregnancy, and a mean follow-up duration of 7.1 ± 1.6 y. Cubic spline graphs identified a threshold effect of low calcium intake only within the range of dietary inadequacy related to increased risk. The lowest calcium quartile (≤738 mg/d; median: 588 mg/d), relative to the highest quartile (≥1254 mg/d), had an HR for hypertension of 1.34 (95% CI: 1.05, 1.70) among women who were normotensive during pregnancy, and an HR of 1.62 (95% CI: 1.14, 2.35) among women who had gestational hypertension, after adjusting for covariates. Women with gestational hypertension, who were in the lowest quartile of calcium intake, and who had a high sodium-to-potassium intake ratio had a risk of hypertension more than double that of their counterparts with a calcium intake in the highest quartile. Results were attenuated by adjusting for covariates (HR: 1.92; 95% CI: 1.09, 3.39).
The results suggest that low dietary calcium intake may be a risk factor or risk marker for the development of hypertension, particularly for women with a history of gestational hypertension.</description><subject>Adult</subject><subject>Antihypertensives</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Calcium</subject><subject>Calcium (dietary)</subject><subject>Calcium - administration & dosage</subject><subject>Calcium - deficiency</subject><subject>Calcium, Dietary - administration & dosage</subject><subject>cardiovascular disease</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Deficiency Diseases - complications</subject><subject>Diet</subject><subject>Drugs</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>gestational hypertension</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - etiology</subject><subject>Hypertension, Pregnancy-Induced</subject><subject>Norway</subject><subject>nutrition</subject><subject>Nutritional Epidemiology</subject><subject>Potassium</subject><subject>Potassium - administration & dosage</subject><subject>preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Complications</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Quartiles</subject><subject>Risk Factors</subject><subject>Sodium</subject><subject>Sodium - administration & dosage</subject><subject>Splines</subject><subject>Women</subject><issn>0022-3166</issn><issn>1541-6100</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUuP0zAUhS0EYsrAki2yxIZNih3bebBAGpXHVCoPiWHBynKcm8YlsTO206q_hT-LoTMjQGLjuzjfPfbxQegpJUtWc_FyZ5eUlstcUJGTe2hBBadZQQm5jxaE5HnGaFGcoUch7AghlNfVQ3SWVyWhrCoW6MfGHfBKDdrMI17bqL4DNhZ_MO3kYWuV1Ue8DvgiBKeNitDig4k9vjxO4CPYYJzFb2APg5tGsPG3mvYpwd9A-YBVF8Hjz7der_BVD_ij8wfYGpXucbFPurItXvVmSKfrnY_4S5zb42P0oFNDgCc38xx9fff2anWZbT69X68uNpnmBYtZyzkTRGiRM1GXWpd5J2reVIQVBSs06-qKiEZ1jVAAVam7WjCmCW-I4Fzpjp2j1yffaW5GaHXK4dUgJ29G5Y_SKSP_Vqzp5dbtpRBlzmuWDF7cGHh3PUOIcjRBwzAoC24Okta0qgRN1ST0-T_ozs3epniJKvK8rCgrE5WdKO1dCB66u8dQIn_VLndWptrlqfbEP_szwR1923MCyhMA6R_3BrwM2oDV0BoPOsrWmf9Y_wTbWLyi</recordid><startdate>20170901</startdate><enddate>20170901</enddate><creator>Egeland, Grace M</creator><creator>Skurtveit, Svetlana</creator><creator>Sakshaug, Solveig</creator><creator>Daltveit, Anne Kjersti</creator><creator>Vikse, Bjørn E</creator><creator>Haugen, Margaretha</creator><general>Elsevier Inc</general><general>American Institute of Nutrition</general><general>American Society for Nutrition</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20170901</creationdate><title>Low Calcium Intake in Midpregnancy Is Associated with Hypertension Development within 10 Years after Pregnancy: The Norwegian Mother and Child Cohort Study</title><author>Egeland, Grace M ; Skurtveit, Svetlana ; Sakshaug, Solveig ; Daltveit, Anne Kjersti ; Vikse, Bjørn E ; Haugen, Margaretha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c463t-d443505c523597cc72f594b8036636c3f9805bafb5aee87cf9533c04b0544acf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Antihypertensives</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Calcium</topic><topic>Calcium (dietary)</topic><topic>Calcium - administration & dosage</topic><topic>Calcium - deficiency</topic><topic>Calcium, Dietary - administration & dosage</topic><topic>cardiovascular disease</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Deficiency Diseases - complications</topic><topic>Diet</topic><topic>Drugs</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>gestational hypertension</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - etiology</topic><topic>Hypertension, Pregnancy-Induced</topic><topic>Norway</topic><topic>nutrition</topic><topic>Nutritional Epidemiology</topic><topic>Potassium</topic><topic>Potassium - administration & dosage</topic><topic>preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Complications</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Quartiles</topic><topic>Risk Factors</topic><topic>Sodium</topic><topic>Sodium - administration & dosage</topic><topic>Splines</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Egeland, Grace M</creatorcontrib><creatorcontrib>Skurtveit, Svetlana</creatorcontrib><creatorcontrib>Sakshaug, Solveig</creatorcontrib><creatorcontrib>Daltveit, Anne Kjersti</creatorcontrib><creatorcontrib>Vikse, Bjørn E</creatorcontrib><creatorcontrib>Haugen, Margaretha</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Egeland, Grace M</au><au>Skurtveit, Svetlana</au><au>Sakshaug, Solveig</au><au>Daltveit, Anne Kjersti</au><au>Vikse, Bjørn E</au><au>Haugen, Margaretha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Low Calcium Intake in Midpregnancy Is Associated with Hypertension Development within 10 Years after Pregnancy: The Norwegian Mother and Child Cohort Study</atitle><jtitle>The Journal of nutrition</jtitle><addtitle>J Nutr</addtitle><date>2017-09-01</date><risdate>2017</risdate><volume>147</volume><issue>9</issue><spage>1757</spage><epage>1763</epage><pages>1757-1763</pages><issn>0022-3166</issn><eissn>1541-6100</eissn><abstract>Low dietary calcium intake may be a risk factor for hypertension, but studies conflict.
We evaluated the ability to predict hypertension within 10 y after delivery based on calcium intake during midpregnancy.
The Norwegian Mother and Child Cohort Study of women delivering in 2004-2009 was linked to the Norwegian Prescription Database (2004-2013) to ascertain antihypertensive medication usage >90 d after delivery. Women with hypertension before pregnancy were excluded, leaving 60,027 mothers for analyses. Age and energy-adjusted cubic splines evaluated dose-response curves, and Cox proportional hazard analyses evaluated HR and 95% CIs by calcium quartiles adjusting for 7 covariates. Analyses were stratified by gestational hypertension and by sodium-to-potassium intake ratio (<0.76 compared with ≥0.76).
Participants had a mean ± SD age of 30.5 ± 4.6 y, a body mass index (in kg/m2) of 24.0 ± 4.3 before pregnancy, and a mean follow-up duration of 7.1 ± 1.6 y. Cubic spline graphs identified a threshold effect of low calcium intake only within the range of dietary inadequacy related to increased risk. The lowest calcium quartile (≤738 mg/d; median: 588 mg/d), relative to the highest quartile (≥1254 mg/d), had an HR for hypertension of 1.34 (95% CI: 1.05, 1.70) among women who were normotensive during pregnancy, and an HR of 1.62 (95% CI: 1.14, 2.35) among women who had gestational hypertension, after adjusting for covariates. Women with gestational hypertension, who were in the lowest quartile of calcium intake, and who had a high sodium-to-potassium intake ratio had a risk of hypertension more than double that of their counterparts with a calcium intake in the highest quartile. Results were attenuated by adjusting for covariates (HR: 1.92; 95% CI: 1.09, 3.39).
The results suggest that low dietary calcium intake may be a risk factor or risk marker for the development of hypertension, particularly for women with a history of gestational hypertension.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28701386</pmid><doi>10.3945/jn.117.251520</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Antihypertensives Body mass Body mass index Body size Calcium Calcium (dietary) Calcium - administration & dosage Calcium - deficiency Calcium, Dietary - administration & dosage cardiovascular disease Cohort analysis Cohort Studies Deficiency Diseases - complications Diet Drugs Female Follow-Up Studies gestational hypertension Humans Hypertension Hypertension - etiology Hypertension, Pregnancy-Induced Norway nutrition Nutritional Epidemiology Potassium Potassium - administration & dosage preeclampsia Pregnancy Pregnancy Complications Proportional Hazards Models Prospective Studies Quartiles Risk Factors Sodium Sodium - administration & dosage Splines Women |
| title | Low Calcium Intake in Midpregnancy Is Associated with Hypertension Development within 10 Years after Pregnancy: The Norwegian Mother and Child Cohort Study |
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