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No link between calcium supplements, abdominal aortic calcification among older women
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Older women randomly assigned a daily 1.2 g calcium supplement for 5 years were no more likely to develop abdominal aortic calcification vs. similar women assigned placebo, according to study data presented at the American Society for Bone and Mineral Research annual meeting.
“These data from a large, 5-year, randomized, double-blind, placebo controlled trial of older women did not identify any increase in progression of abdominal aortic calcification, a known predictor of increased risk of CVD, in women randomly assigned to receive a 1,200 mg calcium supplement along with about 900 mg calcium from diet when compared with the placebo group consuming approximately 900 mg dietary calcium per day,” Joshua Lewis, PhD, an adjunct senior lecturer with the School of Medical and Health Sciences, Edith Cowan University, Australia, told Endocrine Today
Lewis and colleagues analyzed data from 904 women aged at least 70 years participating in the Calcium Intake Fracture Outcome study, a 5-year, double-blind, placebo-controlled trial with 1.2 g calcium carbonate. Participants underwent assessments for abdominal aortic calcification in 1998-1999 (baseline) and again in 2003-2004 using lateral spine images captured during bone mineral density testing (mean age at baseline, 75 years). Abdominal aortic calcification was scored using a 24-point scale, with scores ranging from low (score of 0 or 1) to moderate (scores 2-5) and severe (scores > 5).
At baseline, median abdominal aortic calcification score was 2 for the cohort. Researchers did not observe a between-group difference for change in abdominal aortic calcification scores in the intention-to-treat analysis or the per-protocol analysis (n = 626) between the calcium group and placebo groups. Results persisted after adjustment for age, dietary calcium and other cardiovascular risk factors (P difference 0.659 and 0.464, respectively).
In analyses restricted to women with an abdominal aortic calcification score progression of 2 or greater (n = 301; 33.3%), there was no difference between groups in the intention-to-treat analysis (calcium, 34.3% vs. placebo, 32.3%; P = .572) or the per-protocol analyses (calcium, 37% vs. placebo, 30.5%; P = .091). Findings were similar in analyses restricted to women with severe abdominal aortic calcification at baseline.
In assessing women with no abdominal aortic calcification at baseline (n = 180) who went on to develop any abdominal aortic calcification (progression 1; n = 51), researchers similarly observed no difference between groups (calcium, 21.7% vs. placebo, 34%; P = .071).
The researchers noted that women assigned to the calcium group with no abdominal aortic calcification at baseline who took at least 80% of calcium supplements were less likely to go on to develop abdominal aortic calcification when compared with women assigned to placebo (calcium, 23% vs. placebo, 42.4%; P = .032).
“In older women who cannot meet the current recommended intake of calcium from the diet alone, calcium supplementation with vitamin D should continue to be advised to reduce their risk of osteoporotic fracture,” Richard Prince, MD, FRACP, MRCP, a professor of internal medicine at the University of Western Australia Medical School, told Endocrine Today. – by Regina Schaffer
Reference:
Lewis J, et al. Abstract LB-1168. Presented at: American Society of Bone and Mineral Research; Sept. 20-23, 2019; Orlando.
Disclosure: Lewis and Prince report no relevant financial disclosures.