title: The association of calcium supplementation and incident cardiovascular events in the Multi-ethnic Study of Atherosclerosis (MESA).
abstract: Many US adults use calcium supplements to address inadequate dietary intake and improve bone health. However, recent reports have suggested that use of calcium supplements may elevate cardiovascular disease (CVD) risk. In this study, we examined associations between baseline calcium supplement use and incident myocardial infarction (MI) (n = 208 events) and CVD events (n = 641 events) over 10.3 years in men and women from the Multi-Ethnic Study of Atherosclerosis (MESA) cohort (n = 6236), with dietary calcium intake at baseline also examined as a supplementary objective.
  
  
  
  Using Cox proportional hazards models, no compelling associations between calcium intake from supplements or diet and incident CVD events were observed upon multivariate adjustment for potential confounders. An association with lower MI risk was observed comparing those with low levels of calcium supplement use (1-499 mg) to those using no calcium supplements (hazard ratio 0.69, 95% CI 0.48, 0.98, p = 0.039). Relationships were homogeneous by gender, race/ethnicity, or chronic kidney disease. Results were also similar when the analysis was limited to postmenopausal women only.
  
  
  
  Analysis of incident MI and CVD events in the MESA cohort does not support a substantial association of calcium supplement use with negative cardiovascular outcomes.
authors: Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors: L M
authors: LM
authors: Raffield
authors: Department of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL.
authors: S
authors: S
authors: Agarwal
authors: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
authors: F C
authors: FC
authors: Hsu
authors: Division of Nephrology and Kidney Research Institute, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA.
authors: I H
authors: IH
authors: de Boer
authors: Nephrology Section, Veterans Affairs San Diego Healthcare System, Division of Nephrology and Hypertension, University of California School of Medicine, San Diego, CA.
authors: J H
authors: JH
authors: Ix
authors: New York Academy of Medicine, New York, NY.
authors: D
authors: D
authors: Siscovick
authors: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: M
authors: M
authors: Szklo
authors: Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC.
authors: G L
authors: GL
authors: Burke
authors: Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX.
authors: A C
authors: AC
authors: Frazier-Wood
authors: Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC.
authors: D M
authors: DM
authors: Herrington
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002118:Calcium / Q000008:administration & dosage* / Q000009:adverse effects; D002136:Calcium, Dietary / Q000008:administration & dosage; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D019587:Dietary Supplements / Q000009:adverse effects; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology; D017698:Postmenopause; D016016:Proportional Hazards Models; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology
chemical_list: D002136:Calcium, Dietary; D002118:Calcium
keywords: Calcium; Cardiovascular disease; Multi-ethnic Study of Atherosclerosis; Myocardial infarction; Supplements