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Different plasma ionized calcium correlations with blood pressure in high and low renin normotensive adults in Utah
S C Hunt1, R R Williams, H Kuida
1Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City.
Insights
Plasma ionized calcium levels show varied correlations with blood pressure in healthy adults, depending on their plasma renin activity levels. These findings suggest a complex interplay between calcium, renin, and blood pressure regulation.
Area of Science:
- Cardiovascular Physiology
- Endocrinology
- Nephrology
Background:
- Plasma ionized calcium levels differ in hypertensive patients based on plasma renin activity (PRA).
- Previous studies indicate altered calcium-BP relationships in hypertension linked to PRA.
- The relationship between ionized calcium and blood pressure in normotensive individuals across different PRA categories is not well understood.
Purpose of the Study:
- To investigate the relationship between plasma ionized calcium and blood pressure in healthy normotensive individuals.
- To determine if this relationship varies across different categories of plasma renin activity (PRA).
Main Methods:
- Measured plasma ionized calcium and blood pressure (sitting, standing, supine, handgrip, tilt) in 875 healthy individuals (ages 3-83).
- Categorized adults into tertiles based on plasma renin activity (PRA).
- Analyzed correlations between plasma ionized calcium and blood pressure within each PRA tertile.
Main Results:
- No overall linear correlation between plasma ionized calcium and blood pressure in the entire sample.
- In adults, significant inverse correlations (ionized calcium and BP) were found in the low PRA group.
- Significant positive correlations (ionized calcium and systolic BP) were observed in the high PRA group; no significant correlations in the normal PRA group.
Conclusions:
- Plasma ionized calcium exhibits differential correlations with blood pressure in normotensive adults, modulated by plasma renin activity.
- The influence of renin on calcium-BP relationships is more pronounced for systolic than diastolic blood pressure.
- These findings highlight a complex interaction between calcium, renin, and blood pressure regulation in the general population.
Abstract:
Plasma ionized calcium levels have been shown to be lower than normotensive control levels in hypertensive patients with low plasma renin activity and higher than control levels in hypertensive patients with high renin activity; they did not differ between high and low plasma renin activity groups of normotensive controls. To see if ionized calcium may have different relationships with blood pressure across renin categories in normotensive individuals, plasma ionized calcium was measured on 875 healthy individuals, ages 3 to 83, who had never been diagnosed as having hypertension. Blood pressures were measured in the sitting, standing, and supine positions, along with pressures measured during two stress maneuvers: isometric handgrip and a 50 degrees tilt from a supine position. There was no linear correlation of blood pressure with plasma ionized calcium in the entire sample of youths or adults. However, after dividing the adults into tertiles based on plasma renin activity, there were significant inverse correlations between ionized calcium and systolic and diastolic blood pressure in the low renin group (r = -0.16 to -0.25, P less than or equal to .05), while the systolic blood pressure correlations were significantly positive in the high renin group (r = 0.14 to 0.22, P less than or equal to .05). Adults with normal renin levels did not have any significant correlations of plasma ionized calcium with blood pressure. These confounding effects of renin were greater for systolic than for diastolic blood pressure. These correlations within renin tertiles occurred even though there were no differences in mean blood pressure, plasma ionized calcium, total plasma protein and plasma sodium across renin categories.(ABSTRACT TRUNCATED AT 250 WORDS)
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