Best of 2024: Mixed Long-term Effects of Calcium and Vitamin D in Postmenopausal Women

Jack Cush, MD

Dec 30, 2024 7:30 am

This article originally appeared March 11, 2024, and is being shared again as a "Best of 2024". Enjoy!

A follow-up analysis of a randomized clinical trial found that the use of calcium and vitamin D supplements among postmenopausal women was associated with decreased risk for cancer mortality, but increased risk for cardiovascular disease (CVD) mortality. The analysis is published in Annals of Internal Medicine.

A multicenter US trial of 36 282 postmenopausal women randomized 1:1 to either 1000 mg of calcium carbonate (400 mg of elemental calcium) with 400 IU of vitamin D3 daily (CaD group) or placebo. This study was a post hoc analysis of long-term (7-year) followup data and examined rates of colorectal, invasive breast, and total cancer; disease-specific and all-cause mortality; total cardiovascular disease (CVD); and hip fracture.

Compared to placebo, those treated with CaD experienced:

7% decrease in cancer mortality (HR 0.93; 95% CI, 0.87 to 0.99)
6% increase in CVD mortality (HR 1.06; 1.01 to 1.12)
No effect on all-cause mortality (HR, 1.00)

Hip fracture and CVD outcomes were available on only a subset of participants, and effects of calcium versus vitamin D versus joint supplementation could not be disentangled.

Long-Term Effect of Randomization to Calcium and Vitamin D Supplementation on Health in Older Women

Join The Discussion

In the article by Thomson and colleagues (1), the authors identified an error in the description of the calcium dose in the abstract and first paragraph and under Randomization and Interventions in the Methods section. In the abstract and Methods section, the text reads “1000 mg of calcium carbonate (400 mg of elemental calcium).” In the first paragraph, the text reads “(1000 mg of calcium [400 mg of elemental calcium]).” It should read “1000 mg of elemental calcium as calcium carbonate.” The text has been corrected in all places.