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- Title
2011 - Calcium plus vitamin D was associated with increased cardiovascular risk in women not taking personal calcium supplements.
- Authors
Crandall, Carolyn J.; Cauley, Jane A.
- Abstract
Question In postmenopausal women, how does supplementation with calcium plus vitamin D affect cardiovascular (CV) risk in users and nonusers of personal, nonprotocol calcium supplements? Methods Design Subgroup analysis of a randomized placebo-controlled trial (Womens Health Initiative [WHI] Calcium/Vitamin D Supplementation [CaD] study) using a limited access dataset. Analyses were prespecified before access to data was provided. Allocation {Concealed}*.† Blinding Blinded (participants, {clinicians, data collectors, outcome assessors, and data monitoring committee}*).† Follow-up period {Mean 7 years}‡. Setting {40 clinical centers in the USA}‡. Participants 36>282 community-dwelling, postmenopausal women {50 to 79 years of age}‡ (mean age 63 y at WHI CaD study randomization). 54% were taking personal calcium supplements at randomization; users and nonusers of supplements differed on several baseline variables. Intervention Calcium, 1 g/d, plus vitamin D, 400 IU/d (n =>18>176), or placebo (n =>18>106). {Personal, nonprotocol use of calcium >1000 mg/d and vitamin D >1000 IU/d was allowed}‡. Outcomes Myocardial infarction (MI), stroke, coronary revascularization (percutaneous coronary intervention or coronary artery bypass graft), and composites of the individual endpoints with or without death due to coronary heart disease. Patient follow-up {97%}‡ ({intention-to-treat analysis}*). Main results The main results for individual endpoints are shown in the Table. Calcium plus vitamin D was associated with a borderline significant increase in risk for the composite of clinical MI or stroke in nonusers but not in users of personal calcium (P =>0.006 for interaction) (Table); there was no interaction between treatment and personal calcium use for other composite endpoints. Conclusion In postmenopausal women, supplementation with calcium and vitamin D was associated with increased risk for some cardiovascular outcomes in nonusers of personal calcium supplements.
- Publication
ACP Journal Club, 2011, Vol 155, Issue 2, p2
- ISSN
1056-8751
- Publication type
Article