From the Guidelines
Calcium supplements are not associated with an increased risk of deposition into coronary arteries, according to the most recent and highest quality evidence. The relationship between calcium supplementation and coronary artery calcification is complex, but research suggests that there is no established biological mechanism to support an association between calcium and cardiovascular disease 1. In fact, a clinical guideline from the National Osteoporosis Foundation and the American Society for Preventive Cardiology found moderate-quality evidence that calcium with or without vitamin D intake from food or supplements has no relationship with the risk for cardiovascular and cerebrovascular disease, mortality, or all-cause mortality in generally healthy adults 1.
Some key points to consider:
- Obtaining calcium from food sources is preferred, but supplemental calcium can be safely used to correct any shortfalls in intake 1.
- Calcium intake from food and supplements that does not exceed the tolerable upper level of intake (defined by the National Academy of Medicine as 2000 to 2500 mg/d) should be considered safe from a cardiovascular standpoint 1.
- Discontinuation of supplemental calcium for safety reasons is not necessary and may be harmful to bone health when intake from food is suboptimal 1.
- An animal and mechanistic study found no detectable effect of high-calcium diets on coronary artery calcium phosphate deposition in swine with diet-induced metabolic syndrome 1.
Overall, the current evidence suggests that calcium supplements are not a significant risk factor for coronary artery calcification, and individuals can safely use them to support bone health without increasing their risk of cardiovascular disease.
From the Research
Calcium Supplements and Coronary Artery Deposition
- The relationship between calcium supplements and their potential to be deposited into coronary arteries is a topic of concern, with studies indicating varying outcomes 2, 3, 4, 5.
- A study published in the Journal of the American Heart Association found that calcium supplement use was associated with an increased risk for incident coronary artery calcification (CAC) 3.
- Another study published in the Journal of the American College of Nutrition found that calcium supplements might raise the risk of coronary heart disease (CHD), especially myocardial infarction (MI) 4.
- However, dietary calcium intake was not found to increase the risk of cardiovascular disease (CVD), including CHD and stroke 4.
- The mechanism by which calcium supplementation could cause a cardiovascular event is still unclear, but it is suggested that high doses of calcium supplements may lead to hypercalcaemia, which is associated with increased mortality, particularly cardiovascular mortality 5.
Key Findings
- Calcium supplements may increase the risk of cardiovascular events, including myocardial infarction and coronary artery calcification 2, 3, 4.
- Dietary calcium intake does not appear to increase the risk of CVD, including CHD and stroke 4.
- The use of calcium supplements should be approached with caution, and the dose should be adjusted to dietary intake to avoid hypercalcaemia 5.
- More research is needed to fully understand the relationship between calcium supplements and cardiovascular risk 2, 4.