Q:Dr. Si, I recently read that taking calcium supplements can increase the risk of cardiovascular disease. I take calcium tablets so am wondering if this is something I should be concerned about? R.S., Hastings-on-Hudson, NY – SDH
This is one of those situations where a long-standing health practice, the use of calcium supplements to strengthen bones and decrease the risk of fractures, has come under question based on new information.
The recommended daily intake of calcium is 1,200 mg for postmenopausal women, for all women age 51+ and for all men age 71+. Since many of us don’t get the recommended daily calcium in our diets it is common to take some of the many different calcium supplements (pills, tablets, etc.) sold in pharmacies. However, since 2010, a few scientific studies have found that the risk of heart attacks and stroke are higher in people taking these calcium supplements.
We know that an adequate level of calcium is needed for the heart to work correctly and we also know that people who have health conditions that raise calcium above normal levels have an increased risk of heart problems so it makes some sense that taking too much calcium supplementation could cause heart problems. There is no clear answer whether this risk is real or not because some studies have found increased cardiac risk, others have concluded that calcium supplementation poses no heart or stroke risk but at least there is some grounds for concern.
The good news is that getting adequate amounts of calcium through the consumption of calcium-rich foods, rather than by using supplemental pills actually reduces heart-related death and stroke. Getting adequate intake through diet can also have beneficial effects on blood vessels, blood pressure, blood sugar and body weight. And, dietary intake also decreases the risk of kidney stones compared to taking calcium pills. Also, the calcium in foods doesn’t cause the constipation, gas and bloating that pills may cause. Dietary supplementation avoids the temporary calcium increases that tablets cause, which might be the reason that calcium pills could possibly cause an increase in heart risk.
It is important to be aware that the maximum calcium intake (from both diet and any supplements) in people age 51 and older (both men and women) is 2,000 mg. per day. Intake of more than that amount may further increase risk of health problems related to excessive calcium.
At this point we are not sure if calcium supplements really cause heart attack and stroke but it seems clear that, for many reasons, nutritional supplementation is the preferred way to consume adequate calcium rather than relying on calcium pills. I think a reasonable approach is to eat a heart-healthy diet that includes calcium-rich foods, and, even though calcium supplements can be bought without a prescription, it is best to discuss any plan to take calcium with your health care provider to sort out a proper dosage or whether you even need any supplementation.