نمایش مبدأ برای The effect of calcium consumption on cardiovascular diseases

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==Calcium and its importance==
Calcium is one of the body's most common and plentiful minerals and has many essential biologic functions. The body tightly controls circulating calcium levels, usually maintaining a constant range of 1.0 to 1.2 mmol/L. Many medical professionals have suggested increasing calcium intake because of its proposed bone health benefits.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4199062/ Dietary calcium intake and mortality risk from cardiovascular disease and all causes: a meta-analysis of prospective cohort studies]</ref>

Older men and women have widely used calcium supplements. However, in little more than a decade, authoritative recommendations have changed from encouraging the widespread use of calcium supplements to stating that they should not be used for primary prevention of fractures.
The researchers found that calcium supplements were strongly linked to increased cardiovascular disease (CVD) and coronary heart disease (CHD) risk.

==Calcium intake from food sources and calcium supplements==
A 2021 review of studies showed that dietary calcium intake of between 700 to 1,000 milligrams a day or a supplementary intake of 1,000 milligrams a day significantly increased a person's risk of cardiovascular disease and coronary heart disease, which can result in heart attacks. They discovered that healthy postmenopausal women who used calcium supplements had a 15% increased risk of CVD. But the risk of cerebrovascular disease was not significantly correlated with using calcium supplements.
<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910980/ Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials]</ref>

==Comparison between the effects of calcium intake from food sources and calcium supplements==
====Cardiovascular diseases====

In the meta-analysis of calcium monotherapy (without coadministered vitamin D), there was an interaction between dietary calcium intake and the risk of myocardial infarction (MI) with calcium supplements when the cohort was divided by median dietary calcium intake. However, when the cohort was divided by quintile of dietary calcium intake,<ref>[https://pubmed.ncbi.nlm.nih.gov/20671013. Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis]</ref> there was no interaction, and the risk of myocardial infarction (MI)  with calcium was similar in the groups with the lowest and highest calcium intake. 

In the meta-analysis of calcium monotherapy, there was no interaction between dietary calcium intake and the risk of stroke or the composite cardiovascular endpoint in this meta-analysis and no interaction between dietary calcium intake and cardiovascular events in the Women's Health Initiative CaD trial (WHI CaD).<ref>[https://pubmed.ncbi.nlm.nih.gov/23951541 Subgroup analysis for the risk of cardiovascular disease with calcium]</ref> 
<ref>[https://pubmed.ncbi.nlm.nih.gov/17309935 Calcium/vitamin D supplementation and cardiovascular events.]</ref>
Therefore, the increased cardiovascular risk from calcium supplements appears to be independent of dietary calcium intake.<ref>[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4125316/#:~:text=Calcium%2FCaD%20increased%20the%20risk,2011b%5D. Calcium supplements and cardiovascular risk: 5 years on]</ref>.

Researchers in another study concluded that calcium intake from dietary sources does not sufficiently increase the risk of cardiovascular disease, including coronary heart disease and stroke. In contrast, calcium supplements might increase coronary heart disease risk, especially myocardial infarction.<ref>[https://www.tandfonline.com/doi/full/10.1080/07315724.2019.1649219 The Evidence and Controversy Between Dietary Calcium Intake and Calcium Supplementation and the Risk of Cardiovascular Disease: A Systematic Review and Meta-Analysis of Cohort Studies and Randomized Controlled Trials]</ref>

====Metabolic syndrome====
Additionally, a dose-response analysis showed that the risk of metabolic syndrome decreased by 7% for every 300 mg/day increase in dietary calcium consumption. According to these data, the risk of metabolic syndrome may be inversely correlated with dietary calcium consumption.<ref>[https://www.nature.com/articles/s41598-019-55507-x#:~:text=Our%20dose%2Dresponse%20analysis%20revealed,with%20the%20risk%20of%20MetS. Dietary Calcium Intake and the Risk of Metabolic Syndrome: A Systematic Review and Meta-Analysis]</ref>

==Mechanism==
The cause of the increased cardiovascular risk from calcium supplements remains unclear, but potential mechanisms have been extensively reviewed. The finding of increased cardiovascular risk from calcium supplements but not dietary calcium intake in most observational studies have led to the hypothesis that the rapid and sustained increases in serum calcium after ingestion of a calcium supplement may have a central role.<ref>[https://pubmed.ncbi.nlm.nih.gov/23593383 Calcium intake and serum concentration in relation to risk of cardiovascular death in NHANES III]</ref>
<ref>[https://pubmed.ncbi.nlm.nih.gov/23381719 Dietary and supplemental calcium intake and cardiovascular disease mortality: the National Institutes of Health-AARP Diet and Health Study]</ref

 Additionally, increased vascular calcification, recognized as a known risk factor for CVD, may occur due to increased calcium concentrations following calcium administration.
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910980/ Calcium Supplements and Risk of Cardiovascular Disease: A Meta-Analysis of Clinical Trials]</ref>
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==Conclusion==

Recently research suggests a significant increase in incident coronary artery calcification with calcium supplementation. Along with previous data associating calcium supplementation with cardiovascular mortality and all-cause mortality, this new evidence stresses the need for an evidence-based approach to calcium supplementation. Moreover, educating health care providers on the possible risk of excessive and unnecessary calcium supplementation is critical. From a cardiovascular perspective, dietary calcium intake by eating foods high in calcium appears safer than calcium loading with supplements.<ref>[https://onlinelibrary.wiley.com/doi/full/10.1111/jch.13010 Calcium supplementation and cardiovascular risk: A rising concern]</ref>

==Resources==