Recent evidence regarding calcium supplementation and increased risk of MI

Patient

Q: My wife is currently taking 1500 mg of calcium with vitamin D she's very concerned over the study that stated takig calcium could result in heart problems. should she continue with this therapy which was prescibed for the prevention of osteoporosis.

Doctor

A:   Recent evidence has been published regarding the use of calcium supplements and increased risk of heart attack (Myocardial Infarction).The data analysis looked at randomized trials of calcium supplements that supplied at least 500 mg/day of elemental calcium vs placebo. Each of the trials lasted for at least a year and had at least 100 participants with a mean age of 40 years or older. Cardiovascular outcomes were obtained and found that calcium supplements were associated with about a 30% increase in the incidence of MI, however this increase in MI was not associated with an increased risk of stroke or mortality. Until more becomes known about the best way to prevent osteoporotic fractures, patients with osteoporosis should generally not be treated with calcium supplements, either alone or with vitamin D, unless they are also receiving an effective treatment for osteoporosis for a recognized indication. Therefore in your wife’s case, the risks and benefits of treatment must be balanced. If she had a previous osteoporotic fracture, is currently taking Raloxifene, then supplementation would be justified. However if she is taking raloxifene for osteoporosis, without previous fracture history, supplementation may be discontinued and changing to calcium-rich foods may be appropriate. Further research on whether such supplements are needed in addition to effective osteoporosis treatment is urgently required, and I would advise discussing the results of these clinical trials with your wife’s family physician, prior to discontinuation of therapy.

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