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Nutrients 2013, 5(7), 2522-2529; doi:10.3390/nu5072522

Cardiovascular Effects of Calcium Supplements

Faculty of Medical and Health Sciences, University of Auckland, Auckland 1142, New Zealand
Received: 30 May 2013 / Accepted: 14 June 2013 / Published: 5 July 2013
(This article belongs to the Special Issue Calcium Needs of Older Adults)
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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.
Keywords: calcium; myocardial infarction; stroke; osteoporosis calcium; myocardial infarction; stroke; osteoporosis
This is an open access article distributed under the Creative Commons Attribution License (CC BY) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Reid, I.R. Cardiovascular Effects of Calcium Supplements. Nutrients 2013, 5, 2522-2529.

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