Calcium supplementation may lower survival in elderly with aortic stenosis

Calcium supplementation may lower survival in elderly with aortic stenosis

Elderly population is more likely to take calcium supplements with or without vitamin D, mainly for the beneficial effects in bone metabolism. A group of investigators from Cleveland Clinic, headed by Samir R Kapadia sought to check the association between supplemental calcium and vitamin D with mortality and progression in aortic stenosis. Aortic stenosis is the narrowing of the aortic valve, between left ventricle and aorta. Left ventricle is the lower left muscular chamber of the heart. Aorta is the large blood vessel which takes oxygenated blood to the whole body, pumped from the left ventricle.

It was a  study in patients aged 60 years or more who had mild to moderate aortic stenosis. They could compile 2657 patients with a mean age of 74 years and a median follow up period of 69 months for the study. 1292 of them had not taken supplements of either calcium or vitamin D. 332 had taken vitamin D alone, while 1033 took calcium with or without vitamin D. The last group was associated with a significantly higher risk of all-cause mortality, mortality due to heart disease and aortic valve replacement. Aortic valve replacement is usually done in those with severe aortic stenosis having symptoms due to narrowing of the aortic valve.

It is known that deposition of calcium-phosphate crystals can occur in aortic valve leaflets and lead to aortic stenosis. Calcium deposits in the walls of blood vessels can increase their stiffness. Magnesium supplementation has been suggested as a strategy to prevent calcification of blood vessels. But there is a question whether higher doses of magnesium can reduce bone mineral density and lead to a condition called osteomalacia in which the bones are softened!