Evidence map›Paper›PMID 20671013›Full record

SynthesisBMJ (Clinical research ed.)2010

Effect of calcium supplements on risk of myocardial infarction and cardiovascular events: meta-analysis.

Mark J Bolland, Alison Avenell, John A Baron, Andrew Grey, Graeme S MacLennan, Greg D Gamble, Ian R Reid

Open access · bronzeAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 348 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
348citing papers in PubMed, 15 pooled it
82.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

348 citing papers in PubMed, 15 syntheses or guidelines pooled it, 1,091 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Guideline
  12. Pooled it
  13. Recommendations for preventing fracture in long-term care.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2015
    Guideline
  14. Pooled it
  15. Pooled it
  16. Trial
  17. Trial
  18. Trial
  19. Calcium and Vitamin D Supplementation Are Not Associated With Risk of Incident Ischemic Cardiac Events or Death: Findings From the UK Biobank Cohort.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2018
    Trial
  20. Trial

288 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Mark J BollandDepartment of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92 019, Auckland 1142, New Zealand.
Alison Avenell
John A Baron
Andrew Grey
Graeme S MacLennan
Greg D Gamble
Ian R Reid
University of Auckland · NZ

Funding

Colorectal Chemoprevention with Calcium and Vitamin DR01CA098286 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BARON, JOHN ANTHONY · 2003 to 2015
$43.9M
Chief Scientist Office HSRU1NCI NIH HHS R01 CA098286
6 · The paper itself

Abstract

objectiveTo investigate whether calcium supplements increase the risk of cardiovascular events.

designPatient level and trial level meta-analyses. DATA SOURCES: Medline, Embase, and Cochrane Central Register of Controlled Trials (1966-March 2010), reference lists of meta-analyses of calcium supplements, and two clinical trial registries. Initial searches were carried out in November 2007, with electronic database searches repeated in March 2010. STUDY SELECTION: Eligible studies were randomised, placebo controlled trials of calcium supplements (>or=500 mg/day), with 100 or more participants of mean age more than 40 years and study duration more than one year. The lead authors of eligible trials supplied data. Cardiovascular outcomes were obtained from self reports, hospital admissions, and death certificates.

results15 trials were eligible for inclusion, five with patient level data (8151 participants, median follow-up 3.6 years, interquartile range 2.7-4.3 years) and 11 with trial level data (11 921 participants, mean duration 4.0 years). In the five studies contributing patient level data, 143 people allocated to calcium had a myocardial infarction compared with 111 allocated to placebo (hazard ratio 1.31, 95% confidence interval 1.02 to 1.67, P=0.035). Non-significant increases occurred in the incidence of stroke (1.20, 0.96 to 1.50, P=0.11), the composite end point of myocardial infarction, stroke, or sudden death (1.18, 1.00 to 1.39, P=0.057), and death (1.09, 0.96 to 1.23, P=0.18). The meta-analysis of trial level data showed similar results: 296 people had a myocardial infarction (166 allocated to calcium, 130 to placebo), with an increased incidence of myocardial infarction in those allocated to calcium (pooled relative risk 1.27, 95% confidence interval 1.01 to 1.59, P=0.038).

conclusionsCalcium supplements (without coadministered vitamin D) are associated with an increased risk of myocardial infarction. As calcium supplements are widely used these modest increases in risk of cardiovascular disease might translate into a large burden of disease in the population. A reassessment of the role of calcium supplements in the management of osteoporosis is warranted.

Indexed as

AdultAgedBone Density Conservation AgentsCalcium, DietaryDietary SupplementsDrug Therapy, CombinationFemaleHumansMaleMiddle AgedMyocardial InfarctionOsteoporosisRandomized Controlled Trials as TopicRisk FactorsStrokeVitamin DBone Density Conservation AgentsCalcium, DietaryVitamin D

Identifiers

PMID20671013
PMCPMC2912459
OpenAlexW2143921117

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.