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Cardiovascular risks associated with calcium supplementation in patients with osteoporosis: a nationwide cohort study

Authors
Kim, Kyoung JinKim, Min SunHong, NamkiBae, Jae HyunKim, Kyeong JinKim, Nam HoonRhee, YumieLee, JuneyoungKim, Sin Gon
Issue Date
Dec-2022
Publisher
OXFORD UNIV PRESS
Keywords
Calcium; Cardiovascular disease; Osteoporosis; Vitamin D
Citation
European Heart Journal-Cardiovascular Pharmacotherapy, v.8, no.6, pp.568 - 577
Indexed
SCIE
SCOPUS
Journal Title
European Heart Journal-Cardiovascular Pharmacotherapy
Volume
8
Number
6
Start Page
568
End Page
577
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54182
DOI
10.1093/ehjcvp/pvab054
ISSN
2055-6837
Abstract
Aims This study aimed to evaluate the real effects of calcium supplementation on cardiovascular outcomes within a population-based cohort. Methods and results From a nationwide health screening database in South Korea, a total of 11 297 patients with osteoporosis who had taken calcium supplementation with or without vitamin D for at least 90 days [total calcium group; calcium supplementation only (CaO), n = 567; calcium supplementation in combination with vitamin D (CaD), n = 10 730] were matched at a 1:1 ratio to patients who had not taken calcium supplements (control group) by using propensity scores. The overall mean age was 59.9 ± 8.8 years and the percentage of women was 87.9% in our study population. Over a median follow-up of 54 months, the incidence rate of composite cardiovascular diseases (CVDs) per 1000 person-years was not different between the groups: 9.73 in the total calcium group and 8.97 in the control group [adjusted hazard ratio (HR): 1.12; 95% confidence interval (CI): 0.99–1.28; P = 0.08]. However, calcium supplementation without vitamin D was associated with an increased risk of composite CVD (HR: 1.54; 95% CI: 1.17–2.04; P < 0.01), especially non-fatal myocardial infarction (HR: 1.89; 95% CI: 1.23–2.91; P < 0.01), compared with no calcium supplementation. Conclusion Our population-based study supported that taking calcium supplementation combined with vitamin D did not appear to be harmful to cardiovascular health, but reminded that calcium supplementation without vitamin D should be used carefully even in populations with low dietary calcium intake.
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1. Basic Science > Department of Biostatistics > 1. Journal Articles
2. Clinical Science > Department of Endocrinology and Metabolism > 1. Journal Articles

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Kim, Sin Gon
Anam Hospital (Department of Endocrinology and Metabolism, Anam Hospital)
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