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Association Between Calcium Supplementation and Recurrence of Cardiovascular Events in Patients With Cardiovascular

Xiaowen Zhang1, Kathryn Choon-Beng Tan2, Annie Wai-Chee Kung2

  • 1Department of Pharmacology and Pharmacy The University of Hong Kong Pokfulam Hong Kong Special Administrative Region China.

Journal of the American Heart Association
|April 9, 2026
PubMed

Insights

Calcium supplements may increase cardiovascular disease (CVD) recurrence risk in patients with existing CVD. This risk is higher with calcium-only use and in men, suggesting caution is needed.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Cardiovascular safety of calcium supplements in patients with established cardiovascular disease (CVD) is not well understood.
  • This study aimed to investigate the association between calcium supplementation and the risk of CVD recurrence in this population.

Purpose of the Study:

  • To determine if calcium supplementation increases the risk of recurrent cardiovascular events in patients with pre-existing CVD.
  • To explore differences in risk based on calcium formulation (with or without vitamin D) and sex.

Main Methods:

  • Retrospective population-based study in Hong Kong (2006-2015).
  • Included patients aged ≥40 years newly diagnosed with CVD.
  • Used propensity score matching and Cox proportional hazard models to analyze data from 17,720 patients per group.

Main Results:

  • Calcium supplementation was linked to a higher risk of adverse CVD events (HR 1.10) and CVD-related hospitalizations (HR 1.16).
  • Calcium-only supplements showed a greater risk (HR 1.21) compared to calcium with vitamin D (HR 0.97).
  • The association was more pronounced in men (HR 1.15) than women (HR 1.07).

Conclusions:

  • Calcium supplementation is associated with increased CVD recurrence risk in patients with major CVD.
  • Calcium-only use and male sex are associated with a more pronounced risk.
  • Healthcare providers should exercise caution when prescribing or recommending calcium supplements to CVD patients.
Abstract

Keywords:
calcium supplementcardiovascular diseasemyocardial infarctionsecondary preventionvitamin D

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