title: Calcium intake is not associated with increased coronary artery calcification: the Framingham Study.
abstract: BACKGROUND
  Adequate calcium intake is known to protect the skeleton. However, studies that have reported adverse effects of calcium supplementation on vascular events have raised widespread concern.
  
  
  OBJECTIVE
  We assessed the association between calcium intake (from diet and supplements) and coronary artery calcification, which is a measure of atherosclerosis that predicts risk of ischemic heart disease independent of other risk factors.
  
  
  METHODS
  This was an observational, prospective cohort study. Participants included 690 women and 588 men in the Framingham Offspring Study (mean age: 60 y; range: 36-83 y) who attended clinic visits and completed food-frequency questionnaires in 1998-2001 and underwent computed tomography scans 4 y later in 2002-2005.
  
  
  RESULTS
  The mean age-adjusted coronary artery-calcification Agatston score decreased with increasing total calcium intake, and the trend was not significant after adjustment for age, BMI, smoking, alcohol consumption, vitamin D-supplement use, energy intake, and, for women, menopause status and estrogen use. Multivariable-adjusted mean Agatston scores were 2.36, 2.52, 2.16, and 2.39 (P-trend = 0.74) with an increasing quartile of total calcium intake in women and 4.32, 4.39, 4.19, and 4.37 (P-trend = 0.94) in men, respectively. Results were similar for dietary calcium and calcium supplement use.
  
  
  CONCLUSIONS
  Our study does not support the hypothesis that high calcium intake increases coronary artery calcification, which is an important measure of atherosclerosis burden. The evidence is not sufficient to modify current recommendations for calcium intake to protect skeletal health with respect to vascular calcification risk.
authors.affiliation: Department of Medicine, Harvard Medical School and Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA. samelson@hsl.harvard.edu
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Samelson
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Booth
authors.forename: Caroline S
authors.initials: CS
authors.lastname: Fox
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Tucker
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Wang
authors.forename: Udo
authors.initials: U
authors.lastname: Hoffmann
authors.forename: L Adrienne
authors.initials: LA
authors.lastname: Cupples
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: O'Donnell
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Kiel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D002136:Calcium, Dietary / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D019587:Dietary Supplements / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D012727:Sex Characteristics; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed
chemical_list: D002136:Calcium, Dietary