TY - JOUR
T1 - Calcium intake from diet and supplements and the risk of coronary artery calcification and its progression among older adults
T2 - 10-year follow-up of the multi-ethnic study of atherosclerosis (MESA)
AU - Anderson, John J.B.
AU - Kruszka, Bridget
AU - Delaney, Joseph A.C.
AU - He, Ka
AU - Burke, Gregory L.
AU - Alonso, Alvaro
AU - Bild, Diane E.
AU - Budoff, Matthew
AU - Michos, Erin D.
N1 - Publisher Copyright:
© 2016 The Authors.
PY - 2016/10/1
Y1 - 2016/10/1
N2 - Background--Recent randomized data suggest that calcium supplements may be associated with increased risk of cardiovascular disease (CVD) events. Using a longitudinal cohort study, we assessed the association between calcium intake, from both foods and supplements, and atherosclerosis, as measured by coronary artery calcification (CAC). Methods and Results--We studied 5448 adults free of clinically diagnosed CVD (52% female; aged 45-84 years) from the Multi- Ethnic Study of Atherosclerosis. Baseline total calcium intake was assessed from diet (using a food frequency questionnaire) and calcium supplements (by a medication inventory) and categorized into quintiles. Baseline CAC was measured by computed tomography, and CAC measurements were repeated in 2742 participants ≈10 years later. At baseline, mean calcium intakes across quintiles were 313.3, 540.3, 783.0, 1168.9, and 2157.4 mg/day. Women had higher calcium intakes than men. After adjustment for potential confounders, among 1567 participants without baseline CAC, the relative risk (RR) of developing incident CAC over 10 years, by quintile 1 to 5 of calcium intake, were 1 (reference), 0.95 (0.79-1.14), 1.02 (0.85-1.23), 0.86 (0.69-1.05), and 0.73 (0.57-0.93). After accounting for total calcium intake, calcium supplement use was associated with increased risk for incident CAC (RR=1.22 [1.07-1.39]). No relation was found between baseline calcium intake and 10-year changes in logtransformed CAC among those participants with baseline CAC > 0. Conclusions--High total calcium intake was associated with a decreased risk of incident atherosclerosis over long-term followup, particularly if achieved without supplement use. However, calcium supplement use may increase the risk for incident CAC.
AB - Background--Recent randomized data suggest that calcium supplements may be associated with increased risk of cardiovascular disease (CVD) events. Using a longitudinal cohort study, we assessed the association between calcium intake, from both foods and supplements, and atherosclerosis, as measured by coronary artery calcification (CAC). Methods and Results--We studied 5448 adults free of clinically diagnosed CVD (52% female; aged 45-84 years) from the Multi- Ethnic Study of Atherosclerosis. Baseline total calcium intake was assessed from diet (using a food frequency questionnaire) and calcium supplements (by a medication inventory) and categorized into quintiles. Baseline CAC was measured by computed tomography, and CAC measurements were repeated in 2742 participants ≈10 years later. At baseline, mean calcium intakes across quintiles were 313.3, 540.3, 783.0, 1168.9, and 2157.4 mg/day. Women had higher calcium intakes than men. After adjustment for potential confounders, among 1567 participants without baseline CAC, the relative risk (RR) of developing incident CAC over 10 years, by quintile 1 to 5 of calcium intake, were 1 (reference), 0.95 (0.79-1.14), 1.02 (0.85-1.23), 0.86 (0.69-1.05), and 0.73 (0.57-0.93). After accounting for total calcium intake, calcium supplement use was associated with increased risk for incident CAC (RR=1.22 [1.07-1.39]). No relation was found between baseline calcium intake and 10-year changes in logtransformed CAC among those participants with baseline CAC > 0. Conclusions--High total calcium intake was associated with a decreased risk of incident atherosclerosis over long-term followup, particularly if achieved without supplement use. However, calcium supplement use may increase the risk for incident CAC.
KW - Calcium
KW - Cardiovascular imaging
KW - Coronary artery calcium
KW - Diet
KW - Epidemiology
UR - http://www.scopus.com/inward/record.url?scp=84994389356&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84994389356&partnerID=8YFLogxK
U2 - 10.1161/JAHA.116.003815
DO - 10.1161/JAHA.116.003815
M3 - Article
C2 - 27729333
AN - SCOPUS:84994389356
SN - 2047-9980
VL - 5
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 10
M1 - e003815
ER -