Cardiovascular Impact of Calcium and Vitamin D Supplements: A Narrative Review

Calcium and vitamin D play an important role in mineral homeostasis and the maintenance of skeletal health. Calcium and vitamin D supplements have been widely used for fracture prevention in elderly populations. Many trials have studied the effectiveness and cardiovascular safety of calcium and vitamin D supplementation, with disparate results. In this review, we summarize the most im-portant trials and systematic reviews. There is significant heterogeneity in clinical trial design, differences in the nature of trial out-comes (self-reported vs. verified), prior calcium intake, and trial size. Inconsistent results have been reported concerning the effects of calcium and vitamin D supplementation on cardiovascular outcomes. Most current guidelines recommend calcium intake of up to 1,200 mg daily, preferably from the diet, without concern for cardiovascular risk. Recommendations regarding vitamin D supple-mentation vary widely. There is compelling evidence from well-conducted randomized trials that modest vitamin D supplementation is safe but does not confer cardiovascular benefit or cardiovascular harm.

Automated summary

Calcium and vitamin D play important roles in mineral homeostasis and skeletal health. The effectiveness and cardiovascular safety of their supplementation have been studied in various trials, yielding inconsistent results. Current guidelines recommend up to 1,200 mg of calcium intake from the diet without concern for cardiovascular risk. Recommendations for vitamin D supplementation vary widely, but well-conducted randomized trials suggest that modest supplementation is safe but does not provide cardiovascular benefits or harms.