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CALCIUM SUPPLEMENTS LINKED TO CARDIOVASCULAR PROBLEMS

Calcium supplements increase the risk of cardiovascular events, according to a study published recently in the British Medical Journal.1 Their use in managing osteoporosis should be re-assessed, according to its authors.

Researchers led by Professor Ian Reid, University of Auckland, New Zealand, reassessed the results of the Women’s Health Initiative (WHI) Calcium/Vitamin D Supplementation Study – a seven year, randomised, placebo controlled trial of calcium and vitamin D (1 g calcium and 400 IU vitamin D daily) in 36,282 community dwelling postmenopausal women.

The original study found no cardiovascular effect of taking combined calcium and vitamin D supplements, but the majority of participants were already taking personal calcium supplements, which may have obscured any adverse effects.  Authors analysed data from 16,718 women who were not taking personal calcium supplements at the start of the trial and found that those allocated to combined calcium and vitamin D supplements were at an increased risk of cardiovascular events, especially myocardial infarction (MI).

By contrast, in women who were taking personal calcium supplements at the start of the trial, combined calcium and vitamin D supplements did not alter their cardiovascular risk. 

The authors suspect that the abrupt change in blood calcium levels after taking a supplement causes the adverse effect, rather than it being related to the total amount of calcium consumed.

Further analyses – adding data from 13 other trials, involving 29,000 people altogether – also found consistent increases in the risk of MI and stroke associated with taking calcium supplements, with or without vitamin D, leading the authors to conclude that these data justify a reassessment of the use of calcium supplements in older people.

But in an accompanying editorial, Professors Bo Abrahamsen and Opinder Sahota argue that there is insufficient evidence available to support or refute the association. 

Because of study limitations, they say “it is not possible to provide reassurance that calcium supplements given with vitamin D do not cause adverse cardiovascular events or to link them with certainty to increased cardiovascular risk. Clearly further studies are needed and the debate remains ongoing.”

References

1. Bolland MJ, Grey A, Avenell A, Gamble GD, Reid IR.  Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ 2011;342:d2040.

Published on: May 6, 2011

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ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

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