Calcium and Cardiovascular Risk?

Evidence has surfaced regarding cardiovascular (CV) risks of calcium and vitamin D supplementation. However, there is variability in results and noted limitations of the studies regarding the impact of calcium supplementation, with or without vitamin D, on CV events. 

Regarding primary prevention of fractures in premenopausal women or in men, the U.S. Preventative Services Task Force (USPSTF) recommendation is that current evidence is insufficient to assess the benefits and risks of combined vitamin D and calcium supplementation. More specifically, evidence is insufficient to assess the benefits and risks of daily supplementation with >400 International Units (IU) of vitamin D and >1,000 mg of calcium. Furthermore, the USPSTF recommends against daily supplementation with <400 IU of vitamin D and <1,000 mg of calcium. 

Pharmacists should encourage consumption of calcium and vitamin D through dietary sources to meet the recommended daily allowances (RDA). The RDA of calcium in adults >51 years of age is 1,200 mg, and the RDA of vitamin D for adults 51 to 70 years of age is 600 IU and 800 IU for adults >70 years of age. Calcium-rich foods include dairy products (milk, yogurt, cheese), some fish (sardines and salmon), and calcium-fortified foods, such as orange juice. Vitamin D–rich foods include fatty fish (salmon and tuna), egg yolks, and vitamin D-fortified foods, such as milk, cereal, and orange juice. 


Marissa C. Salvo, PharmD 
Assistant Clinical Professor, University of Connecticut, School of Pharmacy, Storrs, Connecticut

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