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Is Calcium Linked to CVD in Healthy Adults?

Ann Intern Med; ePub 2016 Oct 25; Kopecky, et al

Publish date:

There is a lack of evidence linking calcium with or without vitamin D supplementation to cardiovascular disease (CVD) in generally healthy adults, according to a new clinical guideline from the National Osteoporosis Foundation and the American Society for Preventive Cardiology. An expert panel was convened to evaluate the effects of dietary and supplemental calcium on CVD based on the existing peer-reviewed scientific literature. Findings and recommendations included:

  • There is moderate-quality evidence (B level) that calcium with or without vitamin D intake from food or supplements has no relationship (beneficial or harmful) to the risk for cardiovascular and cerebrovascular disease, mortality, or all-cause mortality in generally healthy adults at this time.
  • Calcium intake from food and supplements that does not exceed the tolerable upper level of intake (defined by the National Academy of Medicine as 2000 to 2500 mg/d) should be considered safe from a cardiovascular standpoint.

Citation:

Kopecky SL, Bauer DC, Gulati M, et al. Lack of evidence linking calcium with or without vitamin D supplementation to cardiovascular disease in generally healthy adults: A clinical guideline from the National Osteoporosis Foundation and the American Society for Preventive Cardiology. [Published online ahead of print October 25, 2016]. Ann Intern Med. doi:10.7326/M16-1743.

Commentary:

Calcium is important for bone health and is also involved in vascular contraction. Two major meta-analyses that came out about 6 years ago suggested that there may be a link between calcium supplementation, with or without vitamin D, and the risk of subsequent cardiovascular disease, increasing the risk of MI and stroke.1,2 The mechanism by which this might occur has never been fully elucidated. This guideline from the National Osteoporosis Foundation and the American Society for Preventive Cardiology, based on a meta-analysis commissioned to explore the relationship between calcium supplementation and CV outcomes, should reassure us that calcium supplementation is safe from a cardiovascular point-of-view.3 —Neil Skolnik, MD

  1. Bolland MJ, Avenell A, Baron JA, et al. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis. BMJ. 2010;341:c3691. doi:10.1136/bmj.c3691.
  2. 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. doi:10.1136/bmj.d2040.
  3. Chun M, Tang AM, Fu Z, Wang DD, Newberry SJ. Calcium intake and cardiovascular disease risk: An updated systematic review and meta-analysis. [Published online ahead of print October 25, 2016]. Ann Intern Med. doi:10.7326/M16-1165.

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