Calcium Supplements Linked to Worse Outcome in Aortic Stenos
The current study included 2657 patients (mean age, 74 years; 42% women) with mild to moderate native aortic stenosis selected from the Cleveland Clinic Echocardiography Database from 2008 to 2016 and followed for a median duration of 69 months. Of these patients, 49% did not take any calcium or vitamin D supplements, 12% took vitamin D alone, and 1033 (39%) supplemented with calcium with or without vitamin D. Results showed that the absolute risk of cardiovascular mortality was 13.7 per 1000 person-years for patients taking calcium with or without vitamin D supplementation; compared with 9.6 per 1000 person-years in those taking vitamin D only, and 5.8 per 1000 person-years in those taking no supplements. All-cause mortality was also significantly higher with calcium supplementation.

Aortic valve replacement was performed in almost half of the patients taking calcium, compared with only 11% of those not taking any supplements. The risks of all-cause and cardiovascular mortality were also higher in patients supplementing with calcium who did not undergo aortic valve replacement.

Oral calcium supplementation was associated with lower survival and a greater need for aortic valve replacement in elderly patients with mild to moderate aortic stenosis. The study findings suggest that supplemental calcium in this population does not confer any cardiovascular benefit, and instead these relationships should be thoughtfully considered in light of growing evidence and concern for cardiovascular harm particularly with unnecessary supplementation.