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  1. Graeme Jones, professor of rheumatology and epidemiology,
  2. Tania Winzenberg, postdoctoral research fellow
  1. 1Menzies Research Institute, Hobart, Tas, Australia 7000
  1. g.jones@utas.edu.au

    Increased risk of myocardial infarction outweighs the reduction in fractures

    Calcium is an important component of bone, and a sufficient intake of calcium is needed for bone homoeostasis. Calcium supplements can reduce the risk of fractures in elderly women who are deficient in calcium and vitamin D, but data on the risk of adverse effects on cardiovascular outcomes have so far been inconclusive. In their accompanying paper, Bolland and colleagues report a preplanned secondary analysis of their randomised controlled trial of calcium supplements in 1471 postmenopausal women. They analysed the effect of calcium supplements on myocardial infarction, stroke, and sudden death.1

    Calcium and vitamin D supplements have been shown to reduce the risk of hip fractures in elderly institutionalised women who are deficient in calcium and vitamin D.2 More recent large trials based in the community have been negative, but this may have been the result of poor adherence,3 which is particularly important for calcium to be effective. Benefit has been …

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