[The calcium debate--strong bones at the expense of cardiovascular health?].
Ensuring an adequate intake of calcium--by means of supplements, if necessary--is a well-established approach in prevention and therapy of osteoporosis. However, in the meantime concerns have been voiced doubting the safety of calcium supplements. The discussion commenced when a new evaluation of the Auckland calcium intervention study revealed a higher rate of myocardial infarction after administration of calcium, compared to placebo. Two meta-analyses on the cardiovascular risk of calcium supplements supported these findings. Nevertheless, these results are still discussed contentiously. Doubts were increased by the fact that neither a reevaluation of the WHI calcium vitamin D study, nor a current meta-analysis could identify calcium as a cardiovascular risk factor. Against this background the present article analyses the controversial data with respect to the well-known "Hill-criteria" of causality, including consistency of data, magnitude of association, dose-response relationship and biological plausibility.
Alexander
A
Ströhle
Peyman
P
Hadji
Andreas
A
Hahn
D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D002118:Calcium / Q000008:administration & dosage* / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D019587:Dietary Supplements / Q000009:adverse effects; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology; D010024:Osteoporosis / Q000188:drug therapy*; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage
D014807:Vitamin D; D002118:Calcium