Calcium, Magnesium, and Vitamin D Supplementations As Complementary Therapy for Hypertensive Patients: a Systematic Review and Meta-analysis

Overview

Journal BMC Complement Med Ther

Publisher Biomed Central

Specialty Rehabilitation Medicine

Date 2025 Mar 5

PMID 40045266

Authors

Samar A Amer

Dina Essam Abo-Elnour

Abdallah Abbas

Abdelrahman Salah Abdelrahman

Hossam-Eldin Mohamed Hamdy

Samar Kenawy

Menna M Sarhan

Omar Hany Mohamed

Mohamed Yousif Elnaghy

Mohammed Baker

Rawan Medhat El-Gayar

Omnia Samy El-Sayed

Moamen Mostafa Asla

Affiliations

Soon will be listed here.

Abstract

Background: Hypertension, the first global modifiable risk factor for cardiovascular disease (CVD) morbidity and mortality, is a consequential and remediable threat to the health of individuals and society. Therefore, we conducted this study to explore the role of calcium (Ca), magnesium (Mg), and vitamin D (Vit-D) supplementation as complementary therapies for hypertension, focusing on their effects on systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate.

Methods: This systematic review and meta-analysis examined relevant 6509 articles in PubMed, Scopus, Web of Science, and Cochrane CENTRAL up to October 2024. The primary outcome was the difference in blood pressure measurements (systolic and diastolic) and the pulse rate. The extracted data were analyzed using Open Meta Analyst software.

Results: This systematic review and meta-analysis included 40 studies; of them, 24 studies were analyzed. Ca was associated with a significant drop in the DBP (MD: -2.04, 95% CI [-3.39, -0.69], P = 0.01), but not in the SBP (P = 0.34) or pulse rate (P = 0.84). Mg significantly reduced DBP (MD: -1.64, 95% CI [-3.19, -0.09], P = 0.04), but had no significant effect on the SBP (P = 0.16) or pulse rate (P = 0.81). The estimated effect of Vit-D showed a significant reduction in SBP (MD: -2.83, 95% CI [-5.47, -0.199], P = 0.04) and DBP (MD: -1.64, 95% CI [-2.97, -0.3], P = 0.01).

Conclusion: Ca and Mg significantly reduced DBP but had no significant effect on SBP or the pulse rate. Whereas, vitamin D significantly reduced SBP and DBP.

References

Weinberger M, Wagner U, Fineberg N . The blood pressure effects of calcium supplementation in humans of known sodium responsiveness. Am J Hypertens. 1993; 6(9):799-805. DOI: 10.1093/ajh/6.9.799. View

Cunha A, dEl-Rei J, Medeiros F, Umbelino B, Oigman W, Touyz R . Oral magnesium supplementation improves endothelial function and attenuates subclinical atherosclerosis in thiazide-treated hypertensive women. J Hypertens. 2016; 35(1):89-97. DOI: 10.1097/HJH.0000000000001129. View

Bricio-Barrios Rd J, Palacios-Fonseca MSc A, Toro-Equihua M, Sanchez-Ramirez C . Effect of Calcitriol Supplementation on Blood Pressure in Older Adults. J Nutr Gerontol Geriatr. 2016; 35(4):243-252. DOI: 10.1080/21551197.2016.1206499. View

Rhee M, Na S, Kim Y, Lee M, Kim H . Acute effects of cigarette smoking on arterial stiffness and blood pressure in male smokers with hypertension. Am J Hypertens. 2007; 20(6):637-41. DOI: 10.1016/j.amjhyper.2006.12.017. View

. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018; 392(10159):1736-1788. PMC: 6227606. DOI: 10.1016/S0140-6736(18)32203-7. View

Zemel P, Zemel M, Urberg M, DOUGLAS F, Geiser R, Sowers J . Metabolic and hemodynamic effects of magnesium supplementation in patients with essential hypertension. Am J Clin Nutr. 1990; 51(4):665-9. DOI: 10.1093/ajcn/51.4.665. View

Nowson C, Morgan T . Effect of calcium carbonate on blood pressure in normotensive and hypertensive people. Hypertension. 1989; 13(6 Pt 1):630-9. DOI: 10.1161/01.hyp.13.6.630. View

Larsen T, Mose F, Bech J, Hansen A, Pedersen E . Effect of cholecalciferol supplementation during winter months in patients with hypertension: a randomized, placebo-controlled trial. Am J Hypertens. 2012; 25(11):1215-22. DOI: 10.1038/ajh.2012.111. View

Ferrara L, Iannuzzi R, Castaldo A, Iannuzzi A, Dello Russo A, Mancini M . Long-term magnesium supplementation in essential hypertension. Cardiology. 1992; 81(1):25-33. DOI: 10.1159/000175772. View

10.

Cappuccio F, Markandu N, Beynon G, Shore A, Sampson B, Macgregor G . Lack of effect of oral magnesium on high blood pressure: a double blind study. Br Med J (Clin Res Ed). 1985; 291(6490):235-8. PMC: 1416881. DOI: 10.1136/bmj.291.6490.235. View

11.

Goncalves M, Neto M, Cavalcante I, Sebadelhe V, Souza M, Neves J . 200.000 IU of vitamin D does not reduce resting Blood Pressure and Inhibit Post-Exercise Hypotension in elderly women: a pilot study. An Acad Bras Cienc. 2020; 92(1):e20190227. DOI: 10.1590/0001-3765202020190227. View

12.

Laurant P, Touyz R . Physiological and pathophysiological role of magnesium in the cardiovascular system: implications in hypertension. J Hypertens. 2000; 18(9):1177-91. DOI: 10.1097/00004872-200018090-00003. View

13.

Garland C, Bagher P, Powell C, Ye X, Lemmey H, Borysova L . Voltage-dependent Ca entry into smooth muscle during contraction promotes endothelium-mediated feedback vasodilation in arterioles. Sci Signal. 2017; 10(486). DOI: 10.1126/scisignal.aal3806. View

14.

Elnaem M, Mosaad M, Abdelaziz D, Mansour N, Usman A, Elrggal M . Disparities in Prevalence and Barriers to Hypertension Control: A Systematic Review. Int J Environ Res Public Health. 2022; 19(21). PMC: 9655663. DOI: 10.3390/ijerph192114571. View

15.

Cunha A, Umbelino B, Correia M, Neves M . Magnesium and vascular changes in hypertension. Int J Hypertens. 2012; 2012:754250. PMC: 3299255. DOI: 10.1155/2012/754250. View

16.

Banjanin N, Belojevic G . Changes of Blood Pressure and Hemodynamic Parameters after Oral Magnesium Supplementation in Patients with Essential Hypertension-An Intervention Study. Nutrients. 2018; 10(5). PMC: 5986461. DOI: 10.3390/nu10050581. View

17.

Houston M . The role of nutrition and nutraceutical supplements in the treatment of hypertension. World J Cardiol. 2014; 6(2):38-66. PMC: 3935060. DOI: 10.4330/wjc.v6.i2.38. View

18.

Witham M, Price R, Struthers A, Donnan P, Messow C, Ford I . Cholecalciferol treatment to reduce blood pressure in older patients with isolated systolic hypertension: the VitDISH randomized controlled trial. JAMA Intern Med. 2013; 173(18):1672-9. DOI: 10.1001/jamainternmed.2013.9043. View

19.

Lasaridis A, Kaisis C, Zananiri K, Syrganis C, Tourkantonis A . Increased natriuretic ability and hypotensive effect during short-term high calcium intake in essential hypertension. Nephron. 1989; 51(4):517-23. DOI: 10.1159/000185386. View

20.

Lind L, WENGLE B, Wide L, Ljunghall S . Reduction of blood pressure during long-term treatment with active vitamin D (alphacalcidol) is dependent on plasma renin activity and calcium status. A double-blind, placebo-controlled study. Am J Hypertens. 1989; 2(1):20-5. DOI: 10.1093/ajh/2.1.20. View