Calcium intake from diet and supplements and the risk of coronary artery calcification and its progression among older adults: 10-year follow-up of the multi-ethnic study of atherosclerosis (MESA)

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. © 2016 the authors.