Calcio e hipertension inducida por el embarazo
Resumen
La hipertensión inducida por el embarazo es un factor mayor en la morbilidad y mortalidad materna y perinatal. Aunque esta enfermedad es relativamente común, su etiopatogenia es desconocida.
Sin embargo, nuevas evidencias epidemiológicas, experimentales y clínicas en personas no embarazadas y en embarazadas indican que el calcio tiene un rol importante en la regulación de la presión arterial. Específicamente estos estudios sugieren que dietas con bajo contenido de calcio y trastornos en el metabolismo del mismo se asocian con un riesgo aumentado de hipertensión inducida por el embarazo e hipertensión esencial. Teorías recientes se han propuesto para explicar esta relación, las mismas que incluyen defectos sub—celulares en el transporte y/o “ binding” de calcio, vasoconstrición inducida por altos niveles de paratohorma y deficiencia en la síntesis de prostaciclina
asociada con bajos niveles de calcio extracelular. Prescindiendo de los mecanismos involucrados en la relación entre calcio y presión arterial, los resultados de ensayos clínicos sugieren fuertemente que la suplementación diaria con 2g de calcio desde el segundo trimestre de gestación parece ser
una medida efectiva previniendo o reduciendo el riesgo de hipertensión inducida por el embarazo en un número significativo de mujeres. (Revista de la Facultad de Ciencias Médicas (Quito), 12:13., 1987).
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2. Kruppd, Rj\. and Drukker, J.E.: High risk pregnancy. W.B. Saunders. C., Phiíadelphia, 1986.
3. Page, E.W. and Christensen, R.: The impact of mean arterial pressure in the middle trimesteí upon the outcome'* of pregnancy. Amer. J. Obstet. Gynecol. 125: 740,1976.
4. Friedman, E.A. and Neff, R.K.: Pregnancy hypertensión: a systematic eváluation of clinical diagnostic criterio. P.S.G. Publishing Co., Littleton, Mass., 1977.
5. López—Llera, M.: La toxemia del embarazo. Editorial LIMUSA. 2nd ed., México City, 1985.
6. Long, P.A., Abell, D.Á. and Beisher, N.A., Fetal growth retardation and pre—eclampsia. Brit. J. Obstet. Gynecol., 87:13,1980.
7. Sullivan, J.M. Hypertension and pregnancy. YearbookMed. Publ. Co., Chicago, 1986.
8. Gant, N.F. and Worl.ey, R.J.: Hypertension in pregnancy. Appleton—Century—Crofts, 1980.
9. Deutscher, S., Kjelsberg, M.O. and Epstein, F.H. Relationship between toxemia of pregnancy and essential hypertension in a total community. Amer. J. Epidem. 85 (11): 72,1967.
10. Svensson, A., Sigstrom, L., Andersch, B. et al. Maternal hypertension during pregnancy and high blood pressure in children. Clin. Exp. Hypert in Preg. 82 (2): 203.
11. Higgins, M., Keller, J. Moore, F., et al.: Studies of blood pressure in Tecumseh, Michigan. I. Blood pressure in young people and familial characteristics and complications of pregnancy. Amer. J. Epidem. 11:142,1980.
12. Chesley, L.C.: Hypertension disorders o f pregnancy. Appleton—Century—Crofts, New York, 1978.
13. Belizan, J.M. and Villar, J.: The relationship between calcium intake and edema—, proteinuria— and hypertension gestosis: an hypothesis. Amer.J. Clin. Nutr. 33: 2202,1980,
14. Medenhall, A.M. and Drake, J.C.: Calcium deficiency in pregnancy and lactation. Amer. J. Obstet. Gynecol., 2T: 800,1934.
15. Theobald, C.W.: Effect of caléium and vitamins A and D on incidence of pregnancy toxemia. The Lancét 1:1397,1937.
16. Chaudhuri, S.T.: Role óf nutrition in the etiology of toxemia of pregnancy. Amer. J. Obstet. Gynecol. 110: 46,1970.
17. McCarron, D.A. Morris, CJ). and Colé, C.: Dietary calcium vs hüman hypertension. Science. 21:267,1982.
18. Ackley, S. Barrett—Connor, E. and Suarez, L.: Dairy producís, calcium and blood pressure. Amer. J. Clin. Nutr. 38: 457,1983.
19. García—Palmieri, Mil., Costas, R. Jr., Cruz— Vidal, M. et al.: Milk consumption, calcium intake and decreased hypertension in Puerto Rico: Puerto Rico Ilcart Health Program Study. Hypertension. 6:322,1984.
20. Harían, W.R., Hull, A.L., Schmouder, R.L., et al.: Blood pressure and nutrition in adults. Amer. J. Epidem. 120: 17,1984.
21. McCarron, D.Á., Morris, C.D., Hénry, H,J., et al.: Blood pressure and nutrient intake in the United States. Science. 224:1392,1984.
22. Nichaman, N.M., Shekelle, R., Paul, 0.: Diet, alcohol, and blood pressure in the Western Electric Study. Amer. J. Epidem. 120:469, 1984.
23. Gruchow, H.W., Sobocinski, K.A. and Barboriak, JJ. Alcohol, nutrient intake and hypertension in US adults. JAMA. 253:530,^1985.
24. Harían, W.R., Hull, A.L., Landis, J.L., et al.: High blood pressure in older Arriericans: The First National Health and Nutrition Examination Survey. Hypertension. 6 :802,1985.
25. Harían, W.R., Landis, J.R. and Schmouder, R.L.: Blood lead and blood pressure: relationship in adolescent and adult U.S. population. JAMA. 253:530,1985.
26. Johnson, N.E¿, Smith, E.L., and Freudenheim, J. L.: Effects of blood pressure of calcium supplementation Of women. Amer. J. Clin. Nutr. 42: 12,1985.
27. Kromhout, D., Bosscheiter, E.B. and Coulander, G.: Potassium, calcium, alcohol intake and blood pressure: the Zutphen Study. Amer. /. Clin.Nutr. 41:1299,1985.
28. McCarron, D.A. and Moiris, C.D.: Blood pressure response to oral calcium in mild to moderate hypertension: a randomized, doble blind, placebo— controlled crossover trial. Ann. Intern. Med. 103:825,1985.
29. Reed, D., McGee, D., Yamo, K.r et al.: Diet, blood pressure and multicollinearity. Hypertension. 7:405,1985.
30. Sempos, C.T., Cooper, R.S. Johnson, C., et al.: Association of dietary and serum calcium to blood pressure in adults 40—74 years. Amer. J.Epidem. 122:548,1985.
31. Yanamoto, M. and Kuller, L.: Calcium and elevated blood pressure—further evidence from the Three—Area Stroke Mortality Study (1971—(1974). Amer, J. pidem. 122:5I2,1985.“
32. Caggiula, A.W., Milas, N.C., McKenzie, J.M. et al.: Nutrition intake and blood pressure in the Múltiple Risk Factor Intervention Trial. Twenty— sixth Conference on Cardiovascular Disease Epidemiology. Abstraet, 1986.
33. Folsom, A.R., Smith, C.L., Prineas, R.J., et al.: Serum calcium fractions in essential hypertension and matched normotensive subjeets. Hypertension. 8:11,1986.
34. Kok, F.J., Vandenbrouke, V., Vander—Heide— Wessel, C., et al.: Dietary sodium, calcium and potassium in blood pressure. Amer. J. Epidem. 123:1043,1986.
35. Trevisan, M., Krough, V., Farinaro, E., et al.: Relationship between total and varied sources of dietary calcium intake and blood pressure. Society of Epidemiologic Research Annual Meeting. Abstract, 1986.
36. Villar, J., Belizan, JJM., Fischer, PJ.: Epidemiologic observations on the relationship between calcium intake and eclampsia. Internat. J. Gynecol. Obstet. 1:271,1983.
37. McCarron, D.A., Yung, N.N., Ugoretz, B.A. et al.: Disturbances of calcium metabolism in the spontaneously hypertensive rat. Hypertension. 3 (suppl.I): 1162,1981.
38. Bukowski, R.D. and McCarron, D.A.: Altered aortic reactivity and lowered blood pressure associated with high calcium intake. Amer. J. Physiol., submitted anuscript, 1986.
39. Ayachi, S.: Increased dietary calcium lowers blood pressure in the spontaneously hypertensive rat. Metabolism. 28: 1234,1979. 40. Schleiffer, R.F. Prenot, Bertheolot, Á.: Low calcium diet enhances development of hypertension in the spontaneously hipertensive rat. Clin. Exp. Hyperten. A6 : 783,1984.
41. Sterri, N., Golub, M., Nyby, M., et al.: The hypotensive effect of high calcium intake in the SHR is not mediated by decreased vascular reactivity Clin. Research. 34:44A, 1986.
42. Belizan, J.M., Pineda, O, Sainz, E. etal.: Rise of blood pressure in calcium—deprived pregnant rats. Amer. J. Obstet. Gynecol. 141:163,1981.
43. Hatton, D.C., Huie, P.E., Muntzel, M.S., eJJ al.: Stress induced blood pressure responses in SHR: effect of dietary calcium. Amer. J. Physiol. 252: R48,1987.
44. Grobbee, D.E. and Hoffman, A.: Calcium suppleméntation lowers blood pressure in young mildly hypertensive subjeets: a randomized controlled trial. The Lancet II. 703,1986.
45. Luft, F.C., Aronoff, G.R., Sloan, R.S., et al.: Short—term augumented calcium intake has no effect on sodium homeostasis. Clin. Pharmacol. Ther. 39: 414,1986.
46. Belizan, J.M., Villar, J. Pineda, O., et al.: Reduction of blood pressure with calcium supplementation in young adults. JAMA. 249:1161,1983.
47. Resnick, L.M. and Laragh, J.H.: The hypotensive effect of short—term oral calcium loading in essential hypertension. Clin. Research. 31: 334, 1983.
48. McCarron, D.A. and Morris, C.D.: Blood pressure response to oral in persons with mild to moderate hypertension: a randomized, double—blind placebo—controlled, cross—over trial. And. Intern. Med. 103:825,1985.
49. Morris, C.D. and McCarron, D.A.: Calcium supplementation in hypertension: effect after 8and 16 weeks of treatment. Second Annual European Meeting on Ilypertension. Abstract, 1985.
50. Bierenbaum, M.L., Wolf, E., Kleym, D., et al.: Dietary calcium a method of lowering hypertension and hypercholesterolemia. Twenty— sixth Conference on Cardiovascular Disease Epidemiology, American Heart Association, Abstract, 1986.
51. Tabuchi, Y., Ogihara, T., Hashizume, K., et al.: Hypotensive effect of long—term oral calcium supplementation in elderly patients with hypertension. / . Clin. Hyperten.; 1986.
52. Belizan, J.M., Villar, J., Zalazar, A., et al.: Preliminary evidence of the effect of calcium supplémentation on blood pressure in normal pregnant women. Amer. J. Obstet. Gynecol, 146: 175,1983.
53. López—Jaramillo, J.P., Narváez, M., Yépez, R.: Effect of calcium supplementation on the vascular sensitivity to angiotensin II in pregnant women. Amer. J. Obstet. Gynecol. 156: 261; 1987.
54. Narváez, M., Yépez, R. y López—Jaramillo, J. P.: Prevención con calcio de hipertensión por el embarazo en gestantes de riesgo identificadas por “Roll Over Test” . Rev. Facult. de Cieñe. Méd. (Quito), in press, 1987.
55. Kawasaki, Ñ., Matsui, K. Ito, M., et al.: Effect of calcium supplementation on the vascular sensitivy to angiotensin II in pregnant women. Amer. J. Obstet. Gynecol., 153:576, 1985.
56. Resnick, L.M.: Calcium and hypertension: the emerging connection. Ann. Intern. Med. 103: 944,1985.
57. McCarron, D.A.: Is calcium more important the sodium in the pathogenesis of essential hypertensionI. Hypertension. 7: 607,1986.
58. Bohr, D.F. and Webb. R.C.: Mechanism of membrane stabilization by calcium in vascular smooth musclé. Amer. J. Physiol. 246: H324, 1978.
59. Lau, K., Chen, S., Eby, B.; Evidence for the role of PO deficiency in antihyperténsive actions of a high—Ca diet. Amer. J. Physiol. 246: H324,1984.
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2. Kruppd, Rj\. and Drukker, J.E.: High risk pregnancy. W.B. Saunders. C., Phiíadelphia, 1986.
3. Page, E.W. and Christensen, R.: The impact of mean arterial pressure in the middle trimesteí upon the outcome'* of pregnancy. Amer. J. Obstet. Gynecol. 125: 740,1976.
4. Friedman, E.A. and Neff, R.K.: Pregnancy hypertensión: a systematic eváluation of clinical diagnostic criterio. P.S.G. Publishing Co., Littleton, Mass., 1977.
5. López—Llera, M.: La toxemia del embarazo. Editorial LIMUSA. 2nd ed., México City, 1985.
6. Long, P.A., Abell, D.Á. and Beisher, N.A., Fetal growth retardation and pre—eclampsia. Brit. J. Obstet. Gynecol., 87:13,1980.
7. Sullivan, J.M. Hypertension and pregnancy. YearbookMed. Publ. Co., Chicago, 1986.
8. Gant, N.F. and Worl.ey, R.J.: Hypertension in pregnancy. Appleton—Century—Crofts, 1980.
9. Deutscher, S., Kjelsberg, M.O. and Epstein, F.H. Relationship between toxemia of pregnancy and essential hypertension in a total community. Amer. J. Epidem. 85 (11): 72,1967.
10. Svensson, A., Sigstrom, L., Andersch, B. et al. Maternal hypertension during pregnancy and high blood pressure in children. Clin. Exp. Hypert in Preg. 82 (2): 203.
11. Higgins, M., Keller, J. Moore, F., et al.: Studies of blood pressure in Tecumseh, Michigan. I. Blood pressure in young people and familial characteristics and complications of pregnancy. Amer. J. Epidem. 11:142,1980.
12. Chesley, L.C.: Hypertension disorders o f pregnancy. Appleton—Century—Crofts, New York, 1978.
13. Belizan, J.M. and Villar, J.: The relationship between calcium intake and edema—, proteinuria— and hypertension gestosis: an hypothesis. Amer.J. Clin. Nutr. 33: 2202,1980,
14. Medenhall, A.M. and Drake, J.C.: Calcium deficiency in pregnancy and lactation. Amer. J. Obstet. Gynecol., 2T: 800,1934.
15. Theobald, C.W.: Effect of caléium and vitamins A and D on incidence of pregnancy toxemia. The Lancét 1:1397,1937.
16. Chaudhuri, S.T.: Role óf nutrition in the etiology of toxemia of pregnancy. Amer. J. Obstet. Gynecol. 110: 46,1970.
17. McCarron, D.A. Morris, CJ). and Colé, C.: Dietary calcium vs hüman hypertension. Science. 21:267,1982.
18. Ackley, S. Barrett—Connor, E. and Suarez, L.: Dairy producís, calcium and blood pressure. Amer. J. Clin. Nutr. 38: 457,1983.
19. García—Palmieri, Mil., Costas, R. Jr., Cruz— Vidal, M. et al.: Milk consumption, calcium intake and decreased hypertension in Puerto Rico: Puerto Rico Ilcart Health Program Study. Hypertension. 6:322,1984.
20. Harían, W.R., Hull, A.L., Schmouder, R.L., et al.: Blood pressure and nutrition in adults. Amer. J. Epidem. 120: 17,1984.
21. McCarron, D.Á., Morris, C.D., Hénry, H,J., et al.: Blood pressure and nutrient intake in the United States. Science. 224:1392,1984.
22. Nichaman, N.M., Shekelle, R., Paul, 0.: Diet, alcohol, and blood pressure in the Western Electric Study. Amer. J. Epidem. 120:469, 1984.
23. Gruchow, H.W., Sobocinski, K.A. and Barboriak, JJ. Alcohol, nutrient intake and hypertension in US adults. JAMA. 253:530,^1985.
24. Harían, W.R., Hull, A.L., Landis, J.L., et al.: High blood pressure in older Arriericans: The First National Health and Nutrition Examination Survey. Hypertension. 6 :802,1985.
25. Harían, W.R., Landis, J.R. and Schmouder, R.L.: Blood lead and blood pressure: relationship in adolescent and adult U.S. population. JAMA. 253:530,1985.
26. Johnson, N.E¿, Smith, E.L., and Freudenheim, J. L.: Effects of blood pressure of calcium supplementation Of women. Amer. J. Clin. Nutr. 42: 12,1985.
27. Kromhout, D., Bosscheiter, E.B. and Coulander, G.: Potassium, calcium, alcohol intake and blood pressure: the Zutphen Study. Amer. /. Clin.Nutr. 41:1299,1985.
28. McCarron, D.A. and Moiris, C.D.: Blood pressure response to oral calcium in mild to moderate hypertension: a randomized, doble blind, placebo— controlled crossover trial. Ann. Intern. Med. 103:825,1985.
29. Reed, D., McGee, D., Yamo, K.r et al.: Diet, blood pressure and multicollinearity. Hypertension. 7:405,1985.
30. Sempos, C.T., Cooper, R.S. Johnson, C., et al.: Association of dietary and serum calcium to blood pressure in adults 40—74 years. Amer. J.Epidem. 122:548,1985.
31. Yanamoto, M. and Kuller, L.: Calcium and elevated blood pressure—further evidence from the Three—Area Stroke Mortality Study (1971—(1974). Amer, J. pidem. 122:5I2,1985.“
32. Caggiula, A.W., Milas, N.C., McKenzie, J.M. et al.: Nutrition intake and blood pressure in the Múltiple Risk Factor Intervention Trial. Twenty— sixth Conference on Cardiovascular Disease Epidemiology. Abstraet, 1986.
33. Folsom, A.R., Smith, C.L., Prineas, R.J., et al.: Serum calcium fractions in essential hypertension and matched normotensive subjeets. Hypertension. 8:11,1986.
34. Kok, F.J., Vandenbrouke, V., Vander—Heide— Wessel, C., et al.: Dietary sodium, calcium and potassium in blood pressure. Amer. J. Epidem. 123:1043,1986.
35. Trevisan, M., Krough, V., Farinaro, E., et al.: Relationship between total and varied sources of dietary calcium intake and blood pressure. Society of Epidemiologic Research Annual Meeting. Abstract, 1986.
36. Villar, J., Belizan, JJM., Fischer, PJ.: Epidemiologic observations on the relationship between calcium intake and eclampsia. Internat. J. Gynecol. Obstet. 1:271,1983.
37. McCarron, D.A., Yung, N.N., Ugoretz, B.A. et al.: Disturbances of calcium metabolism in the spontaneously hypertensive rat. Hypertension. 3 (suppl.I): 1162,1981.
38. Bukowski, R.D. and McCarron, D.A.: Altered aortic reactivity and lowered blood pressure associated with high calcium intake. Amer. J. Physiol., submitted anuscript, 1986.
39. Ayachi, S.: Increased dietary calcium lowers blood pressure in the spontaneously hypertensive rat. Metabolism. 28: 1234,1979. 40. Schleiffer, R.F. Prenot, Bertheolot, Á.: Low calcium diet enhances development of hypertension in the spontaneously hipertensive rat. Clin. Exp. Hyperten. A6 : 783,1984.
41. Sterri, N., Golub, M., Nyby, M., et al.: The hypotensive effect of high calcium intake in the SHR is not mediated by decreased vascular reactivity Clin. Research. 34:44A, 1986.
42. Belizan, J.M., Pineda, O, Sainz, E. etal.: Rise of blood pressure in calcium—deprived pregnant rats. Amer. J. Obstet. Gynecol. 141:163,1981.
43. Hatton, D.C., Huie, P.E., Muntzel, M.S., eJJ al.: Stress induced blood pressure responses in SHR: effect of dietary calcium. Amer. J. Physiol. 252: R48,1987.
44. Grobbee, D.E. and Hoffman, A.: Calcium suppleméntation lowers blood pressure in young mildly hypertensive subjeets: a randomized controlled trial. The Lancet II. 703,1986.
45. Luft, F.C., Aronoff, G.R., Sloan, R.S., et al.: Short—term augumented calcium intake has no effect on sodium homeostasis. Clin. Pharmacol. Ther. 39: 414,1986.
46. Belizan, J.M., Villar, J. Pineda, O., et al.: Reduction of blood pressure with calcium supplementation in young adults. JAMA. 249:1161,1983.
47. Resnick, L.M. and Laragh, J.H.: The hypotensive effect of short—term oral calcium loading in essential hypertension. Clin. Research. 31: 334, 1983.
48. McCarron, D.A. and Morris, C.D.: Blood pressure response to oral in persons with mild to moderate hypertension: a randomized, double—blind placebo—controlled, cross—over trial. And. Intern. Med. 103:825,1985.
49. Morris, C.D. and McCarron, D.A.: Calcium supplementation in hypertension: effect after 8and 16 weeks of treatment. Second Annual European Meeting on Ilypertension. Abstract, 1985.
50. Bierenbaum, M.L., Wolf, E., Kleym, D., et al.: Dietary calcium a method of lowering hypertension and hypercholesterolemia. Twenty— sixth Conference on Cardiovascular Disease Epidemiology, American Heart Association, Abstract, 1986.
51. Tabuchi, Y., Ogihara, T., Hashizume, K., et al.: Hypotensive effect of long—term oral calcium supplementation in elderly patients with hypertension. / . Clin. Hyperten.; 1986.
52. Belizan, J.M., Villar, J., Zalazar, A., et al.: Preliminary evidence of the effect of calcium supplémentation on blood pressure in normal pregnant women. Amer. J. Obstet. Gynecol, 146: 175,1983.
53. López—Jaramillo, J.P., Narváez, M., Yépez, R.: Effect of calcium supplementation on the vascular sensitivity to angiotensin II in pregnant women. Amer. J. Obstet. Gynecol. 156: 261; 1987.
54. Narváez, M., Yépez, R. y López—Jaramillo, J. P.: Prevención con calcio de hipertensión por el embarazo en gestantes de riesgo identificadas por “Roll Over Test” . Rev. Facult. de Cieñe. Méd. (Quito), in press, 1987.
55. Kawasaki, Ñ., Matsui, K. Ito, M., et al.: Effect of calcium supplementation on the vascular sensitivy to angiotensin II in pregnant women. Amer. J. Obstet. Gynecol., 153:576, 1985.
56. Resnick, L.M.: Calcium and hypertension: the emerging connection. Ann. Intern. Med. 103: 944,1985.
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Weigel M. Calcio e hipertension inducida por el embarazo. Rev Fac Cien Med (Quito) [Internet]. 16 de junio de 2017 [citado 15 de noviembre de 2024];12(3-4):13-26. Disponible en: https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/628
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