Supplemental calcium may do more harm than good in older patients with aortic stenosis

For elderly patients with mild-moderate aortic stenosis (AS), calcium supplementation with or without vitamin D may lead to unfavourable outcomes, such as lower survival and increased risk of aortic valve replacement, according to a study.

Researchers used data from the Cleveland Clinic Echocardiography Database and reviewed the medical records of mild-moderate native AS patients aged ≥60 years who were followed for a median duration of 69 months.

The population comprised 2,657 patients (mean age 74 years, 42 percent women), among whom 1,292 (49 percent) received no supplement, 332 (12 percent) took vitamin D alone, and 1,033 (39 percent) were given calcium with or without vitamin D.

Compared with no supplementation, calcium supplementation was associated with a significantly higher mortality (all-cause, cardiovascular [CV], and non-CV) and aortic valve replacement—the primary study outcomes. The absolute incidence rates were 43.0 per 1,000 person-years for all-cause mortality (hazard ratio [HR], 1.31, 95 percent confidence interval [CI], 1.07–1.62; p=0.009), 13.7 per 1,000 person-years for CV mortality (HR, 2.0, 95 percent CI, 1.31–3.07; p=0.001), and 88.2 per 1,000 person-years for aortic valve replacement (HR, 1.48, 95 percent CI, 1.24–1.78; p<0.001).

In a linear mixed-effects model, none of the supplements examined produced a longitudinal change in AS parameters.