On the link between additional calcium intake and heart disease | Health and Fitness

Dear Doctor: Calcium is frequently recommended to reduce the risk of bone fractures in the elderly, but I’ve read that calcium builds in the arteries and heart. So what choice do women have — die of a hip fracture or die of a heart attack? Personally, I don’t know which would be better.

Dear Reader: You highlight an interesting issue. There is no doubt that calcium is beneficial for bones, with supplementation improving bone density and — at 500 to 1,200 milligrams per day — leading to a 9 to 19 percent decrease in the rate of hip fractures. But it’s true that supplements may have risks as well.

First, for women over 50, supplementation with 1,000 mg of calcium and 400 IU of vitamin D leads to a 17 percent increased risk of kidney stones. Second, calcium supplementation for people with kidney dysfunction or those on dialysis causes increased calcification of blood vessels and a greater risk of heart attacks and strokes.

A 2008 study of 1,471 postmenopausal women in New Zealand compared the effects of 1,000 mg of calcium citrate to those of a placebo. In five years of follow-up, women who took the calcium had an improvement in the ratio of their good to bad cholesterol (HDL/LDL). However, after 2 1/2 years, the group that took the calcium started to show an increased risk of heart attacks; after five years, they had a 49 percent increased risk.

Then there was a 2010 British Medical Journal study that combined data from 11 studies in which women took elemental calcium supplements of 500 mg or more. The studies, which evaluated fracture risk and bone density, weren’t intended to assess heart attack and stroke risk, but researchers did gather data on the conditions. In total, the group that took calcium had a 27 percent increased risk of heart attacks and a 12 percent higher risk (not considered statistically significant) of…

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