Re: Study: calcium supplements raise heart attack risk

On Sep 27, 4:59 pm, MarilynMann <ma...@xxxxxxxxxxx> wrote:
(Circulation. 2007;115:846-854.)

Calcium/Vitamin D Supplementation and Cardiovascular Events

Judith Hsia, MD; Gerardo Heiss, MD, PhD; Hong Ren, MS; Matthew
Allison, MD, MPH; Nancy C. Dolan, MD; Philip Greenland, MD; Susan R.
Heckbert, MD, PhD; Karen C. Johnson, MD, MPH; JoAnn E. Manson, MD,
DrPH; Stephen Sidney, MD, MPH; Maurizio Trevisan, PhD, for the Women's
Health Initiative Investigators>From the Department of Medicine, George Washington University,

Washington, DC (J.H.); Department of Epidemiology, University of North
Carolina School of Public Health, Chapel Hill (G.H.); Fred Hutchinson
Cancer Research Center, Seattle, Wash (H.R.); Department of Family and
Preventive Medicine, University of California at San Diego, San Diego
(M.A.); Departments of Medicine (N.C.D., P.G.) and Preventive Medicine
(P.G.), Northwestern University, Chicago, Ill; Department of
Epidemiology, University of Washington, Seattle (S.R.H.); Department
of Preventive Medicine, University of Tennessee Health Science Center,
Memphis (K.C.J.); Division of Preventive Medicine, Brigham and Women's
Hospital and Harvard Medical School, Boston, Mass (J.E.M.); Kaiser
Permanente, Oakland, Calif (S.S.); and University at Buffalo School of
Public Health and Health Professions, Buffalo, NY (M.T.).

Correspondence to Judith Hsia, MD, 2150 Pennsylvania Ave, NW No. 4-
414, Washington, DC 20037. E-mail jh...@xxxxxxxxxxx

Received November 2, 2006; accepted December 14, 2006.

Background- Individuals with vascular or valvular calcification are at
increased risk for coronary events, but the relationship between
calcium consumption and cardiovascular events is uncertain. We
evaluated the risk of coronary and cerebrovascular events in the
Women's Health Initiative randomized trial of calcium plus vitamin D
supplementation.

Methods and Results- We randomized 36 282 postmenopausal women 50 to
79 years of age at 40 clinical sites to calcium carbonate 500 mg with
vitamin D 200 IU twice daily or to placebo. Cardiovascular disease was
a prespecified secondary efficacy outcome. During 7 years of follow-
up, myocardial infarction or coronary heart disease death was
confirmed for 499 women assigned to calcium/vitamin D and 475 women
assigned to placebo (hazard ratio, 1.04; 95% confidence interval, 0.92
to 1.18). Stroke was confirmed among 362 women assigned to calcium/
vitamin D and 377 assigned to placebo (hazard ratio, 0.95; 95%
confidence interval, 0.82 to 1.10). In subgroup analyses, women with
higher total calcium intake (diet plus supplements) at baseline were
not at higher risk for coronary events (P=0.91 for interaction) or
stroke (P=0.14 for interaction) if assigned to active calcium/vitamin
D.

Conclusions- Calcium/vitamin D supplementation neither increased nor
decreased coronary or cerebrovascular risk in generally healthy
postmenopausal women over a 7-year use period.

The dose of vitamin d in this was so low an that one would expect no
effect.The recommendation in Canada has recently been increased to
about 1500 IU to prevent cancer. Low vitamin d levels are linked with
coronary health.

Prevalence of Cardiovascular Risk Factors and the Serum Levels of 25-
Hydroxyvitamin D in the United States
Data From the Third National Health and Nutrition Examination Survey

David Martins, MD, MS; Myles Wolf, MD, MMSc; Deyu Pan, MS; Ashraf
Zadshir, MD; Naureen Tareen, MD; Ravi Thadhani, MD, MPH; Arnold
Felsenfeld, MD; Barton Levine, MD; Rajnish Mehrotra, MD; Keith Norris,
MD


Arch Intern Med. 2007;167:1159-1165.

Background Results of several epidemiologic and clinical studies have
suggested that there is an excess risk of hypertension and diabetes
mellitus in persons with suboptimal intake of vitamin D.

Methods We examined the association between serum levels of 25-
hydroxyvitamin D (25[OH]D) and select cardiovascular disease risk
factors in US adults. A secondary analysis was performed with data
from the Third National Health and Nutrition Examination Survey, a
national probability survey conducted by the National Center for
Health Statistics between January 1, 1988, and December 31, 1994, with
oversampling of persons 60 years and older, non-Hispanic black
individuals, and Mexican American individuals.

Results There were 7186 male and 7902 female adults 20 years and
older with available data in the Third National Health and Nutrition
Examination Survey. The mean 25(OH)D level in the overall sample was
30 ng/mL (75 nmol/L). The 25(OH)D levels were lower in women, elderly
persons (60 years), racial/ethnic minorities, and participants with
obesity, hypertension, and diabetes mellitus. The adjusted prevalence
of hypertension (odds ratio [OR], 1.30), diabetes mellitus (OR, 1.98),
obesity (OR, 2.29), and high serum triglyceride levels (OR, 1.47) was
significantly higher in the first than in the fourth quartile of serum
25(OH)D levels (P<.001 for all).

Conclusions Serum 25(OH)D levels are associated with important
cardiovascular disease risk factors in US adults. Prospective studies
to assess a direct benefit of cholecalciferol (vitamin D)
supplementation on cardiovascular disease risk factors are warranted.


'One Vitamin May Prevent Heart Disease
Vitamin D, found naturally in sunshine, may help you to live longer.
The opposite is also true. A lack of this important vitamin appears to
put you at a far higher risk for cardiovascular disease, Reuters
reports of a new study from Drew University School of Medicine in Los
Angeles, Calif.
Find out how vitamin D could prevent cancer!

Led by Dr. Keith Norris, the team evaluated the blood levels of
vitamin D and the risk of heart disease in 7,186 men and 7,902 women
using data from the Third National Health and Nutrition Examination
Survey (NHANES III) that was conducted between 1988 and 1994. They
found that women, older people, racial and ethnic minorities, obese
people and those suffering from hypertension or diabetes had the
lowest levels of vitamin D. When these people were compared with those
who had the highest vitamin D levels, the researchers realized those
with the lowest levels were far more likely to have high blood
pressure, diabetes, and obesity--all risk factors for cardiovascular
disease.

Ditch the scale. Forget the BMI. There's a new measurement that is the
best predictor of a future heart attack.

Norris told Reuters that this evidence of the link between heart
disease and vitamin D "reinforces the emerging evidence that suggests
higher levels of vitamin D may be helpful to reduce the risk of
cardiovascular disease." He added, "The potential implications from a
public health and healthcare cost perspective are tremendous, even if
vitamin D only impacts 5 percent to10 percent of heart health."

Drinking milk or eating fish daily--both of which are packed with
vitamin D--will help protect you from developing this deadly disease.
Click to find out what it is.

How much vitamin D should you take? Norris recommends adults take the
FDA recommended daily dose of 800 IU to 1,200 IU daily; however, 2,000
IU per day is required to achieve adequate blood levels of vitamin D
for prevention of cardiovascular disease. "There appears to be good
safety at doses of 2,000 to 3,000 IU per day," he explained to
Reuters. (Do check with your own physician before increasing the
amount of vitamin D you take.) The study findings were published in
the Archives of Internal Medicine, June 2007.

http://webcenters.netscape.compuserve.com/whatsnew/recent.jsp?story=20071006-0630

The Harvard study mentioned earlier used such a small amount of
vitamin d that one must ask if its designed was to produce a null
result.

Thanks Vince



.

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