Supplemental calcium may lower survival in elderly with aortic stenosis

Supplemental calcium 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 [1].

It was a retrospective longitudinal study in patients aged 60 years or more who had mild to moderate aortic stenosis. Primary outcome measures in the study were all-cause mortality and aortic valve replacement. Secondary outcome was progression of aortic stenosis, assessed by aortic valve area, peak and mean gradients.

They could compile 2657 patients with a mean age of 74 years and a median follow up 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, cardiovascular mortality and aortic valve replacement.

Ectopic deposition of calcium-phosphate crystals can occur in aortic valve leaflets and lead to aortic stenosis. Magnesium supplementation has been suggested as a strategy to prevent vascular calcification. But there is a question whether higher doses of magnesium can reduce bone mineral density and lead to osteomalacia [2]!

Reference

1. Kassis N, Hariri EH, Karrthik AK, Ahuja KR, Layoun H, Saad AM, Gad MM, Kaur M, Bazarbashi N, Griffin BP, Popovic ZB, Harb SC, Desai MY, Kapadia SR. Supplemental calcium and vitamin D and long-term mortality in aortic stenosis. Heart. 2022 Apr 25:heartjnl-2021-320215. doi: 10.1136/heartjnl-2021-320215. Epub ahead of print. PMID: 35470234.
2. Donato M, Faggin E, Cinetto F, Felice C, Lupo MG, Ferri N, Rattazzi M. The Emerging Role of Nutraceuticals in Cardiovascular Calcification: Evidence from Preclinical and Clinical Studies. Nutrients. 2021 Jul 28;13(8):2603. doi: 10.3390/nu13082603. PMID: 34444763; PMCID: PMC8401694.