J Am Heart Assoc
Calcium supplements linked to higher risk of recurrent CV events
Clinical Takeaway: Use caution when recommending calcium supplements to patients with established CVD—particularly calcium-only formulations and in men—and reassess the risk–benefit balance for bone health vs. cardiovascular safety.
In a large population-based cohort study, calcium supplementation was linked to a higher risk of recurrent cardiovascular events among patients with pre-existing cardiovascular disease.
Researchers analyzed data from Hong Kong’s territory-wide electronic health records, identifying adults ≥40 years with newly diagnosed CVD between 2006 and 2015. After propensity-score matching, 17,720 calcium users were compared with 17,720 nonusers and followed for recurrent events through 2020.
Calcium supplementation was associated with a 10% higher risk of recurrent adverse cardiovascular events (hazard ratio [HR], 1.10; 95% confidence interval [CI], 1.07–1.14) and a 16% higher risk of CVD-related hospitalization or emergency visits (HR, 1.16; 95% CI, 1.13–1.20).
Risk varied by formulation and sex. Calcium-only supplements carried the highest risk (HR, 1.21; 95% CI, 1.17–1.25), while combinations with vitamin D showed no significant increase (HR, 0.97; 95% CI, 0.93–1.01). The association was stronger in men (HR, 1.15) than women (HR, 1.07).
Given the widespread use of calcium supplements, the authors emphasized that “even a modest increase in recurrence risk has important clinical and public health implications for high-risk populations.” They urge clinicians to carefully weigh cardiovascular risk when prescribing calcium for secondary prevention.
Source: Zhang X, et al. (2026, April 9). J Am Heart Assoc. Association Between Calcium Supplementation and Recurrence of Cardiovascular Events in Patients With Cardiovascular Disease: A Population-Based Cohort Study