Friday, April 22, 2011

OSTEOPOROSIS, CALCIUM, VIT D AND THE HEART

Osteoporosis is a very common problem as we age, especially females. Bones scans are nowadays, part of a diagnostic package offered by many laboratories. Soon after a bone scan showing osteoporosis, subjects, are advised to take all kinds of supplements, often even without a physician or orthopedic consult. Commonly advocated are calcium tablets, Vit D capsules and the light. This is indeed a multi-million dollar industry.
Well, there must now be a serious re-think of this strategy.
The April 19th issue of BMJ carries an article by a group of New Zealand doctors into this issue of Calcium, Vit D and Cardiac and stroke risk. The paper is entitled "Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women's Health
Initiative limited access dataset and meta-analysis. BMJ 2011" The lead author is Dr Bolland, who had written before on this issue. The present study is actually a meta-analysis, combining his earlier study, plus the landmark paper called the Women's Health Initiative, and his current study. The is a total of 30,000 patients in the cohort. They found that taking calcium and Vit D increases your risk of heart attacks by 25-30% and your risk of strokes by 15-20%. Now this is significant.
Obviously, there is some controversy, as the earlier Women's Health Initiative concluded that there was no increase risk. However, in that study, many of those in the placebo arm, were actually consuming their own dietary supplement of Calcium and Vit D. They were not Calcium and Vit D naive. Therefore, their conclusion may have to be taken with a pinch of salt.
As usual, the authors concluded that more studies are needed, but who is going to fund these, "no pharma gain" studies?
For the time being, if I can offer some advice. Please do not consume calcium and Vit D supplements, without proper medical advice. It is not as innocent as you think. There is a link between micro-calcification and the start of coronary artery disease. Also, the age group of people who may suffer from osteoporosis are also the age group of people likely to get heart attacks.
It did cross my mine as to whether giving these people with osteoporosis. and who needs calcium / Vit D some aspirin to mitigate against the risk of heart attacks and strokes.
Interesting idea. I suppose, we do need more clinical studies. Lets see who will take it up.

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