Calcium supplements with or without vitamin D modestly increase the risk of cardiovascular events, especially myocardial infarction, according to a study published in April issue of BMJ (1).
Bolland BJ and colleagues have reanalysed of WHI CaD Study limited access dataset with incorporation of meta-analysis eight other studies have. WHI CaD Study, a seven year, randomized, placebo controlled trial of calcium and vitamin D (1g calcium and 400 IU vitamin D daily) in 36 282 community dwelling postmenopausal women.
Main outcome measure: Incidence of four cardiovascular events and their combinations (myocardial infarction, coronary revascularisation, death from coronary heart disease, and stroke) assessed with patient-level data and trial-level data.
The results of WHI CaD Study show that there is an interaction between personal use of calcium supplements and allocated calcium and vitamin D for cardiovascular events. In the 16 718 women (46%) who were not taking personal calcium supplements at randomization the hazard ratios for cardiovascular events with calcium and vitamin D ranged from 1.13 to 1.22 (P=0.05 for clinical myocardial infarction or stroke, P=0.04 for clinical myocardial infarction or revascularisation), whereas in the women taking personal calcium supplements cardiovascular risk did not alter with allocation to calcium and vitamin D.
In meta-analyses of three placebo controlled trials, calcium and vitamin D increased the risk of myocardial infarction (relative risk 1.21 (P=0.04), stroke (P=0.05), and the composite of myocardial infarction or stroke (P=0.02).
Calcium or calcium and vitamin D increased the risk of myocardial infarction (P=0.004) and the composite of myocardial infarction or stroke (P=0.009).
The authors concluded that Calcium supplements with or without vitamin D modestly increase the risk of cardiovascular events, especially myocardial infarction. This finding was obscured in the WHI CaD Study by the widespread use of personal calcium supplements.
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