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Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg).
Heart. 2012 Jun; 98(12):920-5.H

Abstract

BACKGROUND

It has been suggested that a higher calcium intake might favourably modify cardiovascular risk factors. However, findings of an ultimately decreased risk of cardiovascular disease (CVD) are limited. Instead, recent evidence warns that taking calcium supplements might increase myocardial infarction (MI) risk.

OBJECTIVE

To prospectively evaluate the associations of dietary calcium intake and calcium supplementation with MI and stroke risk and overall CVD mortality.

METHODS

Data from 23 980 Heidelberg cohort participants of the European Prospective Investigation into Cancer and Nutrition study, aged 35-64 years and free of major CVD events at recruitment, were analysed. Multivariate Cox regression models were used to estimate HRs and 95% CIs.

RESULTS

After an average follow-up time of 11 years, 354 MI and 260 stroke cases and 267 CVD deaths were documented. Compared with the lowest quartile, the third quartile of total dietary and dairy calcium intake had a significantly reduced MI risk, with a HR of 0.69 (95% CI 0.50 to 0.94) and 0.68 (95% CI 0.50 to 0.93), respectively. Associations for stroke risk and CVD mortality were overall null. In comparison with non-users of any supplements, users of calcium supplements had a statistically significantly increased MI risk (HR=1.86; 95% CI 1.17 to 2.96), which was more pronounced for calcium supplement only users (HR=2.39; 95% CI 1.12 to 5.12).

CONCLUSIONS

Increasing calcium intake from diet might not confer significant cardiovascular benefits, while calcium supplements, which might raise MI risk, should be taken with caution.

Authors+Show Affiliations

Division of Cancer Epidemiology, German Cancer Research Centre, Heidelberg, Germany.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22626900

Citation

Li, Kuanrong, et al. "Associations of Dietary Calcium Intake and Calcium Supplementation With Myocardial Infarction and Stroke Risk and Overall Cardiovascular Mortality in the Heidelberg Cohort of the European Prospective Investigation Into Cancer and Nutrition Study (EPIC-Heidelberg)." Heart (British Cardiac Society), vol. 98, no. 12, 2012, pp. 920-5.
Li K, Kaaks R, Linseisen J, et al. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg). Heart. 2012;98(12):920-5.
Li, K., Kaaks, R., Linseisen, J., & Rohrmann, S. (2012). Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg). Heart (British Cardiac Society), 98(12), 920-5. https://doi.org/10.1136/heartjnl-2011-301345
Li K, et al. Associations of Dietary Calcium Intake and Calcium Supplementation With Myocardial Infarction and Stroke Risk and Overall Cardiovascular Mortality in the Heidelberg Cohort of the European Prospective Investigation Into Cancer and Nutrition Study (EPIC-Heidelberg). Heart. 2012;98(12):920-5. PubMed PMID: 22626900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg). AU - Li,Kuanrong, AU - Kaaks,Rudolf, AU - Linseisen,Jakob, AU - Rohrmann,Sabine, PY - 2012/5/26/entrez PY - 2012/5/26/pubmed PY - 2012/7/27/medline SP - 920 EP - 5 JF - Heart (British Cardiac Society) JO - Heart VL - 98 IS - 12 N2 - BACKGROUND: It has been suggested that a higher calcium intake might favourably modify cardiovascular risk factors. However, findings of an ultimately decreased risk of cardiovascular disease (CVD) are limited. Instead, recent evidence warns that taking calcium supplements might increase myocardial infarction (MI) risk. OBJECTIVE: To prospectively evaluate the associations of dietary calcium intake and calcium supplementation with MI and stroke risk and overall CVD mortality. METHODS: Data from 23 980 Heidelberg cohort participants of the European Prospective Investigation into Cancer and Nutrition study, aged 35-64 years and free of major CVD events at recruitment, were analysed. Multivariate Cox regression models were used to estimate HRs and 95% CIs. RESULTS: After an average follow-up time of 11 years, 354 MI and 260 stroke cases and 267 CVD deaths were documented. Compared with the lowest quartile, the third quartile of total dietary and dairy calcium intake had a significantly reduced MI risk, with a HR of 0.69 (95% CI 0.50 to 0.94) and 0.68 (95% CI 0.50 to 0.93), respectively. Associations for stroke risk and CVD mortality were overall null. In comparison with non-users of any supplements, users of calcium supplements had a statistically significantly increased MI risk (HR=1.86; 95% CI 1.17 to 2.96), which was more pronounced for calcium supplement only users (HR=2.39; 95% CI 1.12 to 5.12). CONCLUSIONS: Increasing calcium intake from diet might not confer significant cardiovascular benefits, while calcium supplements, which might raise MI risk, should be taken with caution. SN - 1468-201X UR - https://www.unboundmedicine.com/medline/citation/22626900/Associations_of_dietary_calcium_intake_and_calcium_supplementation_with_myocardial_infarction_and_stroke_risk_and_overall_cardiovascular_mortality_in_the_Heidelberg_cohort_of_the_European_Prospective_Investigation_into_Cancer_and_Nutrition_study__EPIC_Heidelberg__ L2 - http://heart.bmj.com/cgi/pmidlookup?view=long&pmid=22626900 DB - PRIME DP - Unbound Medicine ER -