Calcium – Vitamin D Supplementation: Effect on Heart Disease and Mortality?

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 HospitalMedicalResearch.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 To do this we undertook a meta-analysis of published and unpublished data from patient level and cluster randomized controlled trials of calcium supplements with or without vitamin D in elderly women.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.

Citation:

The effects of calcium supplementation on coronary heart disease hospitalisation and death in postmenopausal women: a collaborative meta-analysis of randomised controlled trials

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.