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Ca supplements increase mi meta analysis

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This meta-analysis show that calcium supplements may increase the risk of heart attack

Publicada em: Saúde e medicina
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Ca supplements increase mi meta analysis

  1. 1. www.pronutritionist.net Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta- analysis. Bolland MJ et al. BMJ 2010;341:c3691 Page 1 Bolland MJ et al. BMJ 2010;341:c3691
  2. 2. Page 2 Background • Sufficient intake of calcium is essential for bone health • Calcium and vitamin D are considered as basic treatments in fracture prevention among both osteopenic and osteoporotic patients • Previous observational studies have demonstrated positive association between high calcium intake and cardiovascular health • In some recent studies high calcium intake as supplements has been linked to increased risk of cardiovascular events in renal failure • High intake of calcium is also associated to increased incidence of prostate cancer www.pronutritionist.netBolland MJ et al. BMJ 2010;341:c3691
  3. 3. Methods • n=11 921,meta-analysis of randomized placebo controlled trials. Patients were overwhelmingly female, typically osteoporotic seniors • None of the trials included was designed (and powered) for cardiovascular outcomes (mainly fracture prevention studies). • Intervention: minimum 500 mg of calcium daily without concurrent vitamin D • Follow up: ≈ 4 years • End points: MI, stroke, sudden death and their composite end point 3 www.pronutritionist.netBolland MJ et al. BMJ 2010;341:c3691
  4. 4. Results, myocardial infarctions (#) 4 Bolland MJ et al. BMJ 2010;341:c3691 www.pronutritionist.net +27 %
  5. 5. Results, other CV endpoints • No difference in strokes (1.20, 0.96 to 1.50, P=0.11) • No difference in deaths (1.09, 0.96 to 1.23, P=0.18) • No difference in composite end point (1.18, 1.00 to 1.39, P=0.057) 5 Bolland MJ et al. BMJ 2010;341:c3691 www.pronutritionist.net
  6. 6. Discussion • Results of the meta-analysis are in contrast to observational studies, and raise concern about the safety of large scale use of calcium supplementation • As the included studies were not designed to explore cardiovascular events, they are subject to bias • Renal failure is common among elderly females, this meta-analysis and previous studies in renal failure throw doubt on the recommendation of routine calcium supplementation in elderly osteopenia and osteoporosis • Mechanism behind the phenomenon is unknown, vascular calcification is suggested • Authors conclude that reassessment of osteoporosis guidelines is warranted 6 www.pronutritionist.netBolland MJ et al. BMJ 2010;341:c3691
  7. 7. Discussion • Results of the meta-analysis are in contrast to observational studies, and raise concern about the safety of large scale use of calcium supplementation • As the included studies were not designed to explore cardiovascular events, they are subject to bias • Renal failure is common among elderly females, this meta-analysis and previous studies in renal failure throw doubt on the recommendation of routine calcium supplementation in elderly osteopenia and osteoporosis • Mechanism behind the phenomenon is unknown, vascular calcification is suggested • Authors conclude that reassessment of osteoporosis guidelines is warranted 6 www.pronutritionist.netBolland MJ et al. BMJ 2010;341:c3691

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