title: Effects of combined vitamin D--calcium supplements on the cardiovascular system: should we be cautious?
abstract: Despite the growing body of evidence on the potential effects of calcium and vitamin D as monotherapies on different cardiovascular (CV) parameters, the combined supplementation with calcium and vitamin D (CaD), which is most frequently encountered in clinical practice, has not received the attention it deserves. A literature search was conducted via EMBASE and Medline and identified 14 randomised controlled trials (RCTs) and 2 meta-analyses reporting on effects of combined supplementation with CaD on CV events, CV death, blood pressure, lipids, glucose metabolism and weight. Overall, the existing evidence does not support beneficial properties of supplementation with CaD on the CV system, nor does it suggest that a re-appraisal of the use of CaD is necessary due to adverse effects, although increased risk of CV events has been reported by some authors. The guidelines for the use of CaD supplementation need not change until well-conducted RCTs that have CV effects as primary outcomes and adjust for major confounders indicate otherwise.
authors.affiliation: Department of Upper GI Surgery, Gloucestershire Royal Hospital, Great Western Road, Gloucester, GL1 3NN, UK. Electronic address: Dchalloumas@hotmail.co.uk.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Challoumas
authors.affiliation: School of Medicine, Cardiff University, University Hospital of Wales, Heath Park Campus, Cardiff, CF 14 4XW, UK.
authors.forename: Antonio
authors.initials: A
authors.lastname: Stavrou
authors.affiliation: School of Medicine, Cardiff University, University Hospital of Wales, Heath Park Campus, Cardiff, CF 14 4XW, UK.
authors.forename: Agamemnon
authors.initials: A
authors.lastname: Pericleous
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital of Wales, Heath Park Campus, Cardiff, CF 14 4XW, UK.
authors.forename: Georgios
authors.initials: G
authors.lastname: Dimitrakakis
mesh_terms: D002118:Calcium / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000503:physiopathology; D002319:Cardiovascular System / Q000187:drug effects* / Q000503:physiopathology; D019587:Dietary Supplements / Q000009:adverse effects*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D064167:Recommended Dietary Allowances; D018570:Risk Assessment; D012307:Risk Factors; D014807:Vitamin D / Q000009:adverse effects*
chemical_list: D014807:Vitamin D; D002118:Calcium
keywords: Blood pressure; Calcium; Cardiovascular; Diabetes; Effects; Events; Lipids; Supplements; Vitamin D; Weight