This Group of Researchers have discovered a high risk of Myocardial Infarction and Stroke associated with the use of Calcium Supplements and demonstrated no significant benefit with their use.
Their evidence demonstrates you should not be using elemental Calcium Supplements. Mark Bolland Senior research fellow
Andrew Grey Associate professor
Ian Reid Professor Bone and Joint Research Group
Department of Medicine
University of Auckland
bisphosphonate, myocardial infarction, osteoporosis,
stroke, vitamin D
Aust Prescr 2013;36:5–8
Co-administered calcium and vitamin D supplements prevent fractures in institutionalised elderly women, but there is little evidence that the supplements, administered as monotherapies or in combination, prevent fractures in other people in the community.
Calcium and vitamin D supplements are not always necessary for bisphosphonates to be effective. Individuals at high risk for vitamin D
deficiency should be treated with vitamin D supplements before zoledronic acid is prescribed.
There is little evidence that dietary calcium intake is associated with risk of fracture or cardiovascular events, so dietary calcium generally does not require close scrutiny. Calcium supplements increase the risk of myocardial infarction by about 25% and
stroke by 15–20%. The co-administration of vitamin D does not mitigate these risks. Widespread use of calcium supplements to prevent fractures is therefore no longer appropriate.
There was debate in subsequent publications, attempted arguments were well countered
Mark Bolland, Andrew Grey and Ian Reid, the authors of the article, comment:
The appropriate comparison to assess the effect of calcium is between the sunlight arm and the sunlight plus calcium arm, which only differ by use of calcium. This comparison showed increased all-cause and cardiovascular mortality in the sunlight plus calcium arm.
It is not surprising that our article challenges some readers because calcium has long been thought to be safe and effective.
In 2005–06, five large randomised controlled trials were published on calcium with or without vitamin D in community-dwelling individuals with fracture as the primary end point.1-5 The trials provide a strong evidence base to inform clinical practice.
None of them reported statistically significant reductions in fracture, but individual studies reported that calcium increased the risk of hip fracture, 5 cardiovascular events, 5,6 kidney stones,3 and hospitalisation from gastrointestinal symptoms.4,7 Additionally, calcium was poorly tolerated (compliance approximately 50%). Meta-analyses confirmed these findings as discussed in our article.
Individually, concerns regarding the lack of efficacy, safety or poor tolerability of calcium supplements would provide a good reason for revisiting their role, but collectively these concerns provide a
compelling argument against their widespread use. We think that dispassionate reviews of the evidence will lead to similar conclusions to ours, as shown by the US Preventive Services Task Force recently recommending against the use of calcium and vitamin D for primary fracture prevention.
- See more at: http://www.australianprescriber.com/magazine/36/5/148/9#R8
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Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults:
10-Year Follow-up of the Multi-Ethnic Study of Atherosclerosis (MESA)
John J.B. Anderson, PhD; Bridget Kruszka, MPH; Joseph A.C. Delaney, PhD; Ka He, MD, ScD; Gregory L. Burke, MD, MSc;
Alvaro Alonso, MD, PhD; Diane E. Bild, MD, MPH; Matthew Budoff, MD; Erin D. Michos, MD, MHS, FACC, FAHA
Background-—Recent randomized data suggest that calcium supplements may be associated with increased risk of cardiovascular disease (CVD) events. Using a longitudinal cohort study, we assessed the association between calcium intake, from both foods and supplements, and atherosclerosis, as measured by coronary artery calcification (CAC).
Conclusions-—High total calcium intake was associated with a decreased risk of incident atherosclerosis over long-term followup,
particularly if achieved without supplement use. However, calcium supplement use may increase the risk for incident CAC.
( J Am Heart Assoc. 2016;5:e003815 doi: 10.1161/JAHA.116.003815)
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