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Association between serum phosphate and calcium, long-term blood pressure, and mortality in treated hypertensive

Rajan K Patel1, Panniyammakal Jeemon, Kathryn K Stevens

  • 1BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK *Rajan K. Patel and Panniyammakal Jeemon contributed equally to the writing of this article.

Journal of Hypertension
|October 3, 2015
PubMed

Insights

In hypertensive patients, elevated serum phosphate and calcium levels are linked to poorer survival, independent of blood pressure control. Higher phosphate also correlates with worse blood pressure management over time.

Area of Science:

  • Nephrology
  • Cardiology
  • Endocrinology

Background:

  • Bone mineral abnormalities are linked to cardiovascular issues in chronic kidney disease (CKD) and the general population.
  • Hypertension is a major risk factor for cardiovascular morbidity and mortality.

Purpose of the Study:

  • To investigate the impact of baseline serum phosphate and calcium on blood pressure (BP) control and survival in hypertensive adults.
  • To analyze the association between bone mineral parameters and long-term outcomes in a large cohort of hypertensive individuals.

Main Methods:

  • Prospective study of 9260 hypertensive adults followed for 40 years.
  • Longitudinal analysis of blood pressure changes using generalized estimating equations.
  • Survival analysis employing Cox proportional hazards models.

Main Results:

  • Higher baseline serum phosphate was associated with poorer longitudinal systolic blood pressure (SBP) reduction in both men and women.
  • Elevated serum phosphate correlated significantly with all-cause and cardiovascular mortality in men.
  • Serum calcium predicted all-cause and noncardiovascular mortality in both sexes.
  • In hypertensive patients with CKD, higher phosphate levels were linked to reduced survival.

Conclusions:

  • Serum phosphate and calcium levels are significantly associated with reduced all-cause and cardiovascular survival in hypertensive patients.
  • These associations appear independent of blood pressure control.
  • Bone mineral metabolism plays a crucial role in the prognosis of hypertensive individuals.
Abstract

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