Vitamin D and Calcium Supplements: Helpful, Harmful, or Neutral for Cardiovascular Risk?

• Published in: Methodist DeBakey cardiovascular journal Vol. 15; no. 3; pp. 207 - 213
• Main Authors: Heravi, Amir S, Michos, Erin D
• Format: Journal Article
• Language: English
• Published: United States The Methodist Hospital Houston, Texas 01.07.2019
• Subjects: Animals; Biomarkers - blood; Calcium - adverse effects; Calcium - deficiency; Calcium - therapeutic use; Calcium, Dietary - blood; Cardiovascular Diseases - blood; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Dietary Supplements - adverse effects; Humans; Protective Factors; Recommended Dietary Allowances; Review; Risk Assessment; Risk Factors; Treatment Outcome; Vitamin D - adverse effects; Vitamin D - analogs & derivatives; Vitamin D - blood; Vitamin D - therapeutic use; Vitamin D Deficiency - blood; Vitamin D Deficiency - diagnosis; Vitamin D Deficiency - drug therapy; Vitamin D Deficiency - epidemiology; supplements; calcium; cardiovascular risk; vitamin D
• ISSN: 1947-6094; 1947-6108
• DOI: 10.14797/mdcj-15-3-207

Vitamin D has traditionally been known as the "bone vitamin". However, a large body of observational data has also linked low concentrations of serum 25-hydroxyvitamin D (25[OH]D), the primary storage form of vitamin D, to an increased risk of incident cardiovascular disease (CVD) and mortality, garnering public excitement about the purported nonskeletal benefits of vitamin D. Despite this, more recent meta-analyses and randomized clinical trials have failed to find a beneficial effect of vitamin D supplements on CVD and cancer outcomes. These findings, along with the lack of consensus on optimal serum 25(OH)D concentrations, have dampened some of the initial enthusiasm for vitamin D supplements. Residual confounding or reverse causation may explain some of the discrepancy between the observational and trial results. At this time, vitamin D supplements should not be prescribed for the primary purpose of CVD prevention. Adding to this complexity is the fact that many adults take vitamin D and calcium supplements together for bone health, and there is some concern (albeit inconclusive) related to calcium use and increased CVD risk. In this light, it may be best to achieve the recommended daily allowances of calcium intake through food and reserve calcium supplementation only for those at risk for calcium intake deficiency, with the smallest dosage needed after dietary modifications have been exhausted. In this review, we discuss vitamin D and calcium supplementation and how they may affect cardiovascular health.