Calcium & Disease Prevention - Pregnancy-induced hypertension (preeclampsia)

Pregnancy-induced hypertension (PIH) occurs in 10% of pregnancies, and is a major health risk for pregnant women and their unborn children. PIH is a term that includes gestational hypertension, preeclampsia, and eclampsia. Gestational hypertension is defined as an abnormally high blood pressure that usually develops after the 20th week of pregnancy. In addition to gestational hypertension, preeclampsia includes the development of edema (severe swelling) and proteinuria (protein in the urine). Preeclampsia may progress to eclampsia (also called toxemia) in which life-threatening convulsions and coma may occur. Although the cause of PIH is not entirely understood, calcium metabolism appears to play a role. Risk factors for PIH include first pregnancies, multiple gestations (e.g., twins or triplets), chronic high blood pressure, diabetes, and some autoimmune diseases. Data from epidemiologic studies suggests an inverse relationship between calcium intake and the incidence of PIH, but the results of experimental research on calcium supplementation and PIH have been less clear. A systematic review of randomized placebo-controlled studies found that calcium supplementation reduced the incidence of high blood pressure in pregnant women at high risk of PIH, as well as in pregnant women with low dietary calcium intake. However, in women at low risk of PIH and with adequate calcium intake the benefit of calcium supplementation was judged small and unlikely to be clinically significant. A large multi-center clinical trial of Calcium for Preeclampsia Prevention (CPEP) in over 4,500 pregnant women, found no effect of 2,000 mg of supplemental calcium on PIH. However, women in the placebo group had a mean intake of 980 mg/day, while those in the supplemental group had a mean intake of 2,300 mg/day. For the general population, meeting current recommendations for calcium intake during pregnancy may also help prevent PIH. Further research is required to determine whether women at high risk for PIH would benefit from calcium supplementation above the current recommendations.

Lead toxicity

Children who are chronically exposed to lead, even in small amounts, are more likely to develop learning disabilities, behavioral problems, and to have low IQ's. Abnormal growth and neurological development may occur in the infants of women exposed to lead during pregnancy. In adults, lead toxicity may result in kidney damage and high blood pressure. Although the use of lead paint and leaded gasoline has been discontinued in the U.S., lead toxicity continues to be a significant health problem, especially in children living in urban areas. A study of over 300 children aged 1 through 8 years in an urban neighborhood found that 49% had blood lead levels above current guidelines indicating excessive lead exposure, while only 59% of children ages 1-3 years and 41% of children ages 4-8 years had calcium intakes meeting the recommended levels. Adequate calcium intake appears to be protective against lead toxicity in at least two ways. Increased dietary intake of calcium is known to decrease the gastrointestinal absorption of lead. Once lead enters the body it tends to accumulate in the skeleton, where its may remain for more than twenty years. Adequate calcium intake also prevents exposure to lead mobilized from the skeleton during bone demineralization. A recent study of blood lead levels during pregnancy found that women with inadequate calcium intake during the second half of pregnancy were more likely to have elevated blood lead levels, probably related to increased bone demineralization with the release of accumulated lead into the blood. Lead in the blood of a pregnant woman is readily transported across the placenta resulting in fetal lead exposure at a time when the developing nervous system is highly vulnerable. In postmenopausal women, increased calcium intake was associated with decreased blood lead levels, along with other factors known to decrease bone demineralization, for example, estrogen replacement therapy and physical activity

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