Effects of combined vitamin D--calcium supplements on the cardiovascular system: should we be cautious?

Area of Science:

• Cardiovascular Health
• Nutritional Science
• Clinical Practice

Background:

• Calcium and vitamin D are common supplements, often used together (CaD).
• Evidence on monotherapy effects on cardiovascular (CV) parameters exists, but combined CaD effects are less understood.
• CaD supplementation is frequent in clinical practice.

Purpose of the Study:

• To review the existing evidence on the cardiovascular effects of combined calcium and vitamin D supplementation.
• To determine if current guidelines for CaD use require revision based on CV outcomes.

Main Methods:

• A literature search was performed using EMBASE and Medline databases.
• Included 14 randomized controlled trials (RCTs) and 2 meta-analyses.
• Evaluated effects on CV events, CV death, blood pressure, lipids, glucose metabolism, and weight.

Main Results:

• Overall evidence does not support beneficial cardiovascular properties of CaD supplementation.
• Some studies reported an increased risk of CV events with CaD.
• No compelling evidence suggests CaD necessitates a re-appraisal due to adverse effects.

Conclusions:

• Current evidence does not support a beneficial role for CaD in cardiovascular health.
• Existing guidelines for CaD supplementation need not be altered.
• Further well-conducted RCTs with CV outcomes as primary endpoints are needed to confirm these findings.