01 May Calcium – Vitamin D Supplementation: Effect on Heart Disease and Mortality?
MedicalResearch.com Interview with:
Joshua Lewis, Ph.D
Raine Foundation / Alan Robson Fellow
Bone and Vascular Research Group
School of Medicine and Pharmacology
University of Western Australia
Department of Endocrinology and Diabetes
Sir Charles Gairdner Hospital
MedicalResearch.com: What are the main findings of the study?
Dr. Lewis: We tested the hypothesis raised by others that calcium supplementation with or without vitamin D increases coronary heart disease and mortality risk in elderly women. To do this we undertook a meta-analysis of published and unpublished data from patient level and cluster randomized controlled trials of calcium supplements with or without vitamin D in elderly women. Importantly all events included in this large meta-analysis were verified by clinical review, hospital record or death certificate. We did not observe any significant increase in all-cause mortality or coronary heart disease events that included myocardial infarction, angina pectoris and acute coronary syndromes and chronic coronary heart disease.
MedicalResearch.com: Were any of the findings unexpected?
Dr. Lewis: These findings contrast with a previous meta-analyses that has been widely circulated suggesting that calcium supplements with or without vitamin D increased the risk of myocardial infarction by 24%. However this study was planned to avoid the methodical and statistical issues raised concerning the previous meta-analysis.
MedicalResearch.com: What should clinicians and patients take away from your report?
Dr. Lewis: In women who cannot meet the daily calcium requirements (1,300mg) through the diet alone and adequate 25 hydroxyvitamin D levels (> 50nmol/L) through sunlight and diet, supplementation with calcium 500 – 600 mg calcium and vitamin D 800 -1,000 IU should continue to be endorsed especially for those at an increased risk of osteoporosis.
This is a very important public health message for all aging individuals as opposed to expensive currently available pharmaceutical therapy with accepted adverse effects and unproven benefit in patients without a low DXA bone density T score of -2.5.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Lewis: Because the current lifestyle advice for calcium and vitamin D supplementation that has developed over 50 years has recently been criticised, it is now necessary to carry out a large multicentre RCT of calcium with vitamin D supplementation for the prevention of falls, fractures and surrogate markers of fracture risk whilst assessing potential adverse effects in an internationally accepted way.
This research was presented recently at the World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases and was supported by a Raine Medical Research Foundation Grant. The authors have no disclosures to declare.