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Plasma calcium as a predictor of cardiovascular disease in a community-based cohort

John P Walsh1, Mark L Divitini, Matthew W Knuiman

  • 1Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia. john.walsh@health.wa.gov.au

Clinical Endocrinology
|April 16, 2013
PubMed

Insights

Plasma calcium levels predict cardiovascular events in the general population, but this association is explained by conventional risk factors. Elevated calcium is not an independent predictor of cardiovascular disease.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Epidemiology

Background:

  • Primary hyperparathyroidism and calcium supplementation are linked to cardiovascular outcomes.
  • Previous cohort studies on plasma calcium and cardiovascular disease have yielded conflicting results.
  • Understanding the role of plasma calcium in cardiovascular health is crucial for the general population.

Purpose of the Study:

  • To investigate plasma calcium as a predictor of cardiovascular disease in a general population sample.
  • To clarify conflicting findings from previous cohort studies regarding calcium and cardiovascular outcomes.
  • To assess the association between plasma calcium and mortality and cardiovascular events.

Main Methods:

  • Plasma calcium levels were measured in 4003 participants (aged 25-84 years) during the 1994/1995 Busselton Health Survey.
  • Albumin-corrected calcium was analyzed as a predictor of total mortality, cardiovascular mortality, and cardiovascular events using Cox proportional hazards models.
  • Follow-up extended to the end of 2010 to ascertain outcomes.

Main Results:

  • Baseline plasma calcium showed positive associations with body mass index, blood pressure, glucose, and total cholesterol.
  • After adjusting for age and sex, higher plasma calcium was associated with increased cardiovascular events (HR 1.13, P=0.012).
  • Further adjustment for cardiovascular risk factors attenuated these associations, indicating calcium is not an independent predictor.

Conclusions:

  • Plasma calcium predicts cardiovascular events after adjusting for age and sex.
  • The predictive value of plasma calcium for cardiovascular events appears to be mediated by conventional cardiovascular risk factors.
  • Calcium is not an independent predictor of cardiovascular disease in the general population.
Abstract

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