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Circulation. 2004;110:1990-1995
Published online before print September 27, 2004, doi: 10.1161/01.CIR.0000143199.93495.96
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(Circulation. 2004;110:1990-1995.)
© 2004 American Heart Association, Inc.


Hypertension

Maternal Calcium Intake and Offspring Blood Pressure

Matthew W. Gillman, MD, SM; Sheryl L. Rifas-Shiman, MPH; Ken P. Kleinman, ScD; Janet W. Rich-Edwards, ScD; Steven E. Lipshultz, MD

From the Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care (M.W.G., S.L.R.-S., J.W.R.-E., K.K.), Harvard Medical School, and the Departments of Nutrition (M.W.G.) and Maternal and Child Health (J.W.R.-E.), Harvard School of Public Health, Boston, Mass; and the Department of Pediatrics, University of Miami, Miami, Fla (S.E.L.).

Correspondence to Dr. M.W. Gillman, DACP, HMS/HPHC, 133 Brookline Ave, Boston, MA 02215. E-mail matthew_gillman{at}hms.harvard.edu

Received March 26, 2004; revision received June 8, 2004; accepted June 10, 2004.

Background— Few data exist on the intergenerational influence of calcium intake during pregnancy on offspring blood pressure.

Methods and Results— As part of the ongoing US prospective cohort study Project Viva, we analyzed 4091 Dinamap blood pressure measurements from 936 six-month-old infants whose mothers had completed food frequency questionnaires during the second trimester of pregnancy. We used mixed models to estimate effects of maternal calcium intake on offspring systolic blood pressure. Mean±SD daily total maternal calcium intake was 1494±523 mg, consisting of 1230±486 mg from foods and 264±191 mg from supplements. Mean±SD 6-month blood pressure was 89.9±12.9 mm Hg. From bottom to top quartile of dietary calcium from foods adjusted for energy intake and measurement conditions, mean infant systolic blood pressures were 91.0, 90.2, 90.9, and 90.2 mm Hg (trend P=0.62). From calcium supplements only, the values were 91.5, 90.2, 90.4, and 88.4 mm Hg (trend P=0.006). After further adjustment for demographic, anthropometric, dietary, social, and economic variables, the decrease in 6-month systolic blood pressure was –3.0 mm Hg (95% CI, –4.9 to –1.1) for each 500-mg increment of maternal supplemental calcium intake during pregnancy. We did not find evidence of effect modification by maternal vitamin D or potassium intake or by infant body mass index. First-trimester calcium intake was not associated with offspring blood pressure.

Conclusions— These observational data suggest that supplementing maternal midgestational calcium intake may lower offspring blood pressure, thus helping to prevent hypertension in the next generation.


Key Words: pregnancy • calcium • blood pressurepediatrics




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