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Published on: June 2, 2022
Calcium Supplementation, Risk of Cardiovascular Diseases, and Mortality: A Real-World Study of the Korean National
Jae-Min Park1,2, Bora Lee3, Young-Sang Kim4
1Department of Family Medicine, College of Medicine, Gangnam Severance Hospital, Yonsei University, Seoul 06273, Korea.
Insights
Calcium supplementation may increase cardiovascular risks. This study found higher rates of heart attack, stroke, and death in individuals taking calcium supplements compared to controls, suggesting cautious use.
Area of Science:
- Cardiovascular Health
- Nutritional Epidemiology
- Gerontology
Background:
- Limited real-world data exists on calcium supplementation's cardiovascular effects, especially in populations with low dietary calcium.
- Osteoporosis is a common condition necessitating calcium supplementation.
Purpose of the Study:
- To investigate the association between calcium supplementation and cardiovascular outcomes in a large Korean cohort.
- To assess the real-world risks of cardiovascular events linked to calcium intake.
Main Methods:
- A large retrospective cohort study of Korean adults aged 45+ years, comparing calcium supplement users with matched controls.
- Longitudinal data collection until December 2018, utilizing Kaplan-Meier estimation and Cox proportional hazard regression.
Main Results:
- Calcium supplementation was associated with a significantly higher cumulative incidence of acute myocardial infarction, ischemic stroke, and death.
- Adjusted hazard ratios indicated increased risks: 1.14 for myocardial infarction, 1.12 for stroke, and 1.40 for death.
Conclusions:
- Calcium supplementation, particularly for osteoporosis, may elevate cardiovascular risk in real-world settings.
- Caution is advised when prescribing calcium supplements due to potential adverse cardiovascular outcomes.
Abstract:
Few studies have investigated the effects of calcium supplementation on cardiovascular outcomes in individuals with low calcium intake in real-world settings. This study examined the association between calcium supplementation and cardiovascular outcomes in the Korean population in a real-world setting. This large retrospective cohort study included patients aged ≥45 years first prescribed calcium supplements in 2010. Age- and sex-matched controls were recruited among those who had no prescription for calcium supplements. Longitudinal data were collected on 31 December 2018. Kaplan−Meier estimation and Cox proportional hazard regression analysis were performed. The cumulative incidence of acute myocardial infarction, ischemic stroke, and death was significantly higher in the calcium supplementation group than in the control group (p < 0.05 by log-rank test). The calcium supplementation group had a significantly higher risk of myocardial infarction, ischemic stroke, and death than the control group. Compared to the control group, the hazard ratios (95% confidence intervals) of the incidence of myocardial infarction, stroke, and death in the supplementation group were 1.14 (1.03−1.27), 1.12 (1.05−1.20), and 1.40 (1.32−1.50), respectively, after adjusting for confounding variables. Considering the associated cardiovascular risk, calcium supplementation for osteoporosis treatment should be administered cautiously.
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