Are low intakes of calcium and potassium important causes of cardiovascular disease?

Inadequate levels of calcium and potassium intake have long been associated with higher blood pressures. Epidemiologic data have suggested these assoc iations and many clinical trials have indicated causal relationships. Howev er, the intervention data are plagued with inconsistent study designs, popu lations, and results, and there remain many questions regarding dietary rec ommendations of these nutrients for cardiovascular health. Until recently, nutrition research focused on single-nutrient interventions, generally with disparate results. Recognizing that nutrients are not consumed individuall y but as combined constituents of a varied diet, efforts in this area have shifted to the role of the overall diet, or dietary patterns, in blood pres sure and cardiovascular disease. The suggestions of epidemiologic surveys n early two decades ago that the total diet has a greater influence on cardio vascular health than do specific components, are now being borne out by ran domized controlled trials demonstrating this effect. From these dietary pat tern studies, it has become increasingly clear that it is not merely excess es of single nutrients but also deficiencies of multiple nutrients in combi nation, such as calcium and potassium, that have the greatest dietary effec ts on cardiovascular health. Several risk factors for cardiovascular diseas e have now been shown to be reduced with diets that meet the current recomm ended dietary guidelines, ie, that provide appropriate levels of vitamins, minerals, fiber, and macronutrients. In addition, new data indicate that re gular consumption of these diets is associated with decreased mortality. Ad equate intake of minerals such as calcium and potassium-specifically derive d from foods, where they coexist with other essential nutrients-contributes to cardiovascular as well as overall health. (C) 2001 American Journal of Hypertension, Ltd.