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Preventing pregnancy-induced hypertension: the role of calcium and magnesium.

We read with interest the paper by Lopez-Jaramillo et al. [1] with respect to preventing pregnancy-induced hypertension. The authors state that several meta-analyses have been published demonstrating the relationship between calcium supplementation and pre-eclampsia risk reduction [2–4]. Recently, Atallah et al. [5] published a meta-analysis of 11 randomized trials comparing at least 1 g daily of calcium supplementation during pregnancy with placebo. They found a risk reduction in the incidence of pre-eclampsia with calcium supplementation [11 trials, 6894 women; relative risk (RR) 1⁄4 0.35; 95% confidence interval (CI) 1⁄4 0.2–0.6]. The effect was greater among 587 women at high risk (e.g. teenagers, a past history of pre-eclampsia, women with increased sensitivity to angiotensin II, women with pre-existing hypertension) as reported in five studies (RR 1⁄4 0.22; 95% CI 1⁄4 0.12–0.42) and in 1842 women with low baseline calcium intake as reported in six trials (RR 1⁄4 0.29; 95% CI 1⁄4 0.16–0.54).