Abstract 9231: The Association of Calcium Supplementation and Incident Cardiovascular Events: Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Introduction: Some reports indicate that calcium supplements are associated with adverse cardiovascular (CVD) events in post-menopausal women. We investigated the association between calcium supplements and CVD events in a multi-ethnic cohort.

Methods: We studied 6,237 participants (2472 Caucasian, 790 Chinese, 1615 African-American, and 1360 Hispanic) in the Multi-Ethnic Study of Atherosclerosis (MESA), a population-based cohort study of adults, ages 45-84, free of clinical CVD who had data on dietary calcium intake, calcium supplements and covariates. Cox proportional hazard models were used to study the association between daily calcium supplements (none [reference], 1-500 mg, 500-1000 mg, and >1000 mg) and 6.1 year incident CVD events after adjusting for age, race, sex, education level, household income, site, total and HDL cholesterol, dietary calcium intake, lipid medication use, systolic blood pressure, anti-hypertensive medications, diabetes status, body mass index (BMI), estimated glomerular filtration rate (eGFR), physical activity, and smoking.

Results: Calcium supplements were taken by 2,870 MESA participants. There were 357 CVD events over 6.1 years of follow up. The cumulative 6.1 year CVD event rate for calcium supplement was 5.5% versus 6.4% for non-users. Adjusted hazard ratio (HR, 95% CI) for incident CVD for any calcium supplementation versus none was 0.92 (0.74-1.14). HR's (95%CI) were: Calcium 1-500: 0.84 (0.64-1.08); Calcium 500-1000: 0.89 (0.58-1.32); and Calcium 1000 mg: 1.21 (0.84-1.70). In a similar separate analysis of postmenopausal women (n=2,703), calcium supplement, as in above-mentioned categories, was not associated with incident CVD events. Additionally, no significant interaction was noted between calcium supplements and incident CVD events by race or chronic kidney disease (CKD=eGFR ≤ 60 ml/min/1.73 m²), (calcium x race, p=0.3; calcium x CKD, p=0.9).

Conclusion: In this multi-ethnic observational cohort calcium supplementation was not associated with incident CVD events in either men or women including postmenopausal women.