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Cardiovascular effects of calcium supplements.

Abstract

Calcium supplements reduce bone turnover and slow the rate of bone loss. However, few studies have demonstrated reduced fracture incidence with calcium supplements, and meta-analyses show only a 10% decrease in fractures, which is of borderline statistical and clinical significance. Trials in normal older women and in patients with renal impairment suggest that calcium supplements increase the risk of cardiovascular disease. To further assess their safety, we recently conducted a meta-analysis of trials of calcium supplements, and found a 27%-31% increase in risk of myocardial infarction, and a 12%-20% increase in risk of stroke. These findings are robust because they are based on pre-specified analyses of randomized, placebo-controlled trials and are consistent across the trials. Co-administration of vitamin D with calcium does not lessen these adverse effects. The increased cardiovascular risk with calcium supplements is consistent with epidemiological data relating higher circulating calcium concentrations to cardiovascular disease in normal populations. There are several possible pathophysiological mechanisms for these effects, including effects on vascular calcification, vascular cells, blood coagulation and calcium-sensing receptors. Thus, the non-skeletal risks of calcium supplements appear to outweigh any skeletal benefits, and are they appear to be unnecessary for the efficacy of other osteoporosis treatments.

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  • Authors+Show Affiliations

    Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand. i.reid@auckland.ac.nz

    Source

    Nutrients 5:7 2013 Jul 05 pg 2522-9

    MeSH

    Bone and Bones
    Calcium, Dietary
    Cardiovascular Diseases
    Cardiovascular System
    Dietary Supplements
    Female
    Humans
    Meta-Analysis as Topic
    Randomized Controlled Trials as Topic
    Risk Factors

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    23857224

    Citation

    Reid, Ian R.. "Cardiovascular Effects of Calcium Supplements." Nutrients, vol. 5, no. 7, 2013, pp. 2522-9.
    Reid IR. Cardiovascular effects of calcium supplements. Nutrients. 2013;5(7):2522-9.
    Reid, I. R. (2013). Cardiovascular effects of calcium supplements. Nutrients, 5(7), pp. 2522-9. doi:10.3390/nu5072522.
    Reid IR. Cardiovascular Effects of Calcium Supplements. Nutrients. 2013 Jul 5;5(7):2522-9. PubMed PMID: 23857224.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cardiovascular effects of calcium supplements. A1 - Reid,Ian R, Y1 - 2013/07/05/ PY - 2013/05/30/received PY - 2013/06/14/accepted PY - 2013/7/17/entrez PY - 2013/7/17/pubmed PY - 2014/1/31/medline SP - 2522 EP - 9 JF - Nutrients JO - Nutrients VL - 5 IS - 7 N2 - Calcium supplements reduce bone turnover and slow the rate of bone loss. However, few studies have demonstrated reduced fracture incidence with calcium supplements, and meta-analyses show only a 10% decrease in fractures, which is of borderline statistical and clinical significance. Trials in normal older women and in patients with renal impairment suggest that calcium supplements increase the risk of cardiovascular disease. To further assess their safety, we recently conducted a meta-analysis of trials of calcium supplements, and found a 27%-31% increase in risk of myocardial infarction, and a 12%-20% increase in risk of stroke. These findings are robust because they are based on pre-specified analyses of randomized, placebo-controlled trials and are consistent across the trials. Co-administration of vitamin D with calcium does not lessen these adverse effects. The increased cardiovascular risk with calcium supplements is consistent with epidemiological data relating higher circulating calcium concentrations to cardiovascular disease in normal populations. There are several possible pathophysiological mechanisms for these effects, including effects on vascular calcification, vascular cells, blood coagulation and calcium-sensing receptors. Thus, the non-skeletal risks of calcium supplements appear to outweigh any skeletal benefits, and are they appear to be unnecessary for the efficacy of other osteoporosis treatments. SN - 2072-6643 UR - https://www.unboundmedicine.com/medline/citation/23857224/full_citation L2 - http://www.mdpi.com/resolver?pii=nu5072522 DB - PRIME DP - Unbound Medicine ER -