Calcium/vitamin D supplementation and cardiovascular events.
BACKGROUND
Individuals with vascular or valvular calcification are at increased risk for coronary events, but the relationship between calcium consumption and cardiovascular events is uncertain. We evaluated the risk of coronary and cerebrovascular events in the Women's Health Initiative randomized trial of calcium plus vitamin D supplementation.


RESULTS
We randomized 36,282 postmenopausal women 50 to 79 years of age at 40 clinical sites to calcium carbonate 500 mg with vitamin D 200 IU twice daily or to placebo. Cardiovascular disease was a prespecified secondary efficacy outcome. During 7 years of follow-up, myocardial infarction or coronary heart disease death was confirmed for 499 women assigned to calcium/vitamin D and 475 women assigned to placebo (hazard ratio, 1.04; 95% confidence interval, 0.92 to 1.18). Stroke was confirmed among 362 women assigned to calcium/vitamin D and 377 assigned to placebo (hazard ratio, 0.95; 95% confidence interval, 0.82 to 1.10). In subgroup analyses, women with higher total calcium intake (diet plus supplements) at baseline were not at higher risk for coronary events (P=0.91 for interaction) or stroke (P=0.14 for interaction) if assigned to active calcium/vitamin D.


CONCLUSIONS
Calcium/vitamin D supplementation neither increased nor decreased coronary or cerebrovascular risk in generally healthy postmenopausal women over a 7-year use period.
Hsia
Judith
J
Department of Medicine, George Washington University, Washington, DC, USA. jhsia@mfa.gwu.edu
Heiss
Gerardo
G
Ren
Hong
H
Allison
Matthew
M
Dolan
Nancy C
NC
Greenland
Philip
P
Heckbert
Susan R
SR
Johnson
Karen C
KC
Manson
JoAnn E
JE
Sidney
Stephen
S
Trevisan
Maurizio
M
D000368:Aged; D002119:Calcium Carbonate / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D019587:Dietary Supplements; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D014807:Vitamin D / Q000009:adverse effects* / Q000627:therapeutic use
D014807:Vitamin D; D002119:Calcium Carbonate