Calcium Supplementation, Risk of Cardiovascular Diseases, and Mortality: A Real-World Study of the Korean National Health Insurance Service Data
Few studies have investigated the effects of calcium supplementation on cardiovascular outcomes in individuals with low calcium intake in real-world settings. This study examined the association between calcium supplementation and cardiovascular outcomes in the Korean population in a real-world sett...
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| Veröffentlicht in: | Nutrients 2022-06, Vol.14 (12), p.2538 |
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| creator | Park, Jae-Min Lee, Bora Kim, Young-Sang Hong, Kyung-Won Park, Yon Chul Shin, Dong Hyeok Kim, Yonghwan Han, Kunhee Kim, Kwangyoon Shin, Junghwa Kim, Mina Kim, Bom-Taeck |
| description | Few studies have investigated the effects of calcium supplementation on cardiovascular outcomes in individuals with low calcium intake in real-world settings. This study examined the association between calcium supplementation and cardiovascular outcomes in the Korean population in a real-world setting. This large retrospective cohort study included patients aged ≥45 years first prescribed calcium supplements in 2010. Age- and sex-matched controls were recruited among those who had no prescription for calcium supplements. Longitudinal data were collected on 31 December 2018. Kaplan−Meier estimation and Cox proportional hazard regression analysis were performed. The cumulative incidence of acute myocardial infarction, ischemic stroke, and death was significantly higher in the calcium supplementation group than in the control group (p < 0.05 by log-rank test). The calcium supplementation group had a significantly higher risk of myocardial infarction, ischemic stroke, and death than the control group. Compared to the control group, the hazard ratios (95% confidence intervals) of the incidence of myocardial infarction, stroke, and death in the supplementation group were 1.14 (1.03−1.27), 1.12 (1.05−1.20), and 1.40 (1.32−1.50), respectively, after adjusting for confounding variables. Considering the associated cardiovascular risk, calcium supplementation for osteoporosis treatment should be administered cautiously. |
| doi_str_mv | 10.3390/nu14122538 |
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This study examined the association between calcium supplementation and cardiovascular outcomes in the Korean population in a real-world setting. This large retrospective cohort study included patients aged ≥45 years first prescribed calcium supplements in 2010. Age- and sex-matched controls were recruited among those who had no prescription for calcium supplements. Longitudinal data were collected on 31 December 2018. Kaplan−Meier estimation and Cox proportional hazard regression analysis were performed. The cumulative incidence of acute myocardial infarction, ischemic stroke, and death was significantly higher in the calcium supplementation group than in the control group (p < 0.05 by log-rank test). The calcium supplementation group had a significantly higher risk of myocardial infarction, ischemic stroke, and death than the control group. Compared to the control group, the hazard ratios (95% confidence intervals) of the incidence of myocardial infarction, stroke, and death in the supplementation group were 1.14 (1.03−1.27), 1.12 (1.05−1.20), and 1.40 (1.32−1.50), respectively, after adjusting for confounding variables. Considering the associated cardiovascular risk, calcium supplementation for osteoporosis treatment should be administered cautiously.</description><identifier>ISSN: 2072-6643</identifier><identifier>EISSN: 2072-6643</identifier><identifier>DOI: 10.3390/nu14122538</identifier><identifier>PMID: 35745268</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Age ; Biomedical materials ; Calcium ; Calcium, Dietary ; Cardiovascular diseases ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cerebral infarction ; Comorbidity ; Confidence intervals ; Death ; Diet therapy ; Dietary Supplements ; Health aspects ; Health hazards ; Health insurance ; Health risks ; Heart attacks ; Humans ; Ischemia ; Ischemic Stroke ; Mortality ; Myocardial infarction ; Myocardial Infarction - complications ; National Health Programs ; Osteoporosis ; Population ; Rank tests ; Regression analysis ; Republic of Korea - epidemiology ; Retrospective Studies ; Risk ; Risk Factors ; Statistical analysis ; Stroke ; Stroke - complications</subject><ispartof>Nutrients, 2022-06, Vol.14 (12), p.2538</ispartof><rights>COPYRIGHT 2022 MDPI AG</rights><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c473t-f8336ec530fa1de4056ddd7f1aa018dd05e9b7373e16c210eb895939cce9310d3</citedby><cites>FETCH-LOGICAL-c473t-f8336ec530fa1de4056ddd7f1aa018dd05e9b7373e16c210eb895939cce9310d3</cites><orcidid>0000-0002-9965-675X ; 0000-0001-8873-8832 ; 0000-0002-3137-4609 ; 0000-0002-7397-5410 ; 0000-0003-3180-4565</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9230596/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9230596/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35745268$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Jae-Min</creatorcontrib><creatorcontrib>Lee, Bora</creatorcontrib><creatorcontrib>Kim, Young-Sang</creatorcontrib><creatorcontrib>Hong, Kyung-Won</creatorcontrib><creatorcontrib>Park, Yon Chul</creatorcontrib><creatorcontrib>Shin, Dong Hyeok</creatorcontrib><creatorcontrib>Kim, Yonghwan</creatorcontrib><creatorcontrib>Han, Kunhee</creatorcontrib><creatorcontrib>Kim, Kwangyoon</creatorcontrib><creatorcontrib>Shin, Junghwa</creatorcontrib><creatorcontrib>Kim, Mina</creatorcontrib><creatorcontrib>Kim, Bom-Taeck</creatorcontrib><title>Calcium Supplementation, Risk of Cardiovascular Diseases, and Mortality: A Real-World Study of the Korean National Health Insurance Service Data</title><title>Nutrients</title><addtitle>Nutrients</addtitle><description>Few studies have investigated the effects of calcium supplementation on cardiovascular outcomes in individuals with low calcium intake in real-world settings. This study examined the association between calcium supplementation and cardiovascular outcomes in the Korean population in a real-world setting. This large retrospective cohort study included patients aged ≥45 years first prescribed calcium supplements in 2010. Age- and sex-matched controls were recruited among those who had no prescription for calcium supplements. Longitudinal data were collected on 31 December 2018. Kaplan−Meier estimation and Cox proportional hazard regression analysis were performed. The cumulative incidence of acute myocardial infarction, ischemic stroke, and death was significantly higher in the calcium supplementation group than in the control group (p < 0.05 by log-rank test). The calcium supplementation group had a significantly higher risk of myocardial infarction, ischemic stroke, and death than the control group. Compared to the control group, the hazard ratios (95% confidence intervals) of the incidence of myocardial infarction, stroke, and death in the supplementation group were 1.14 (1.03−1.27), 1.12 (1.05−1.20), and 1.40 (1.32−1.50), respectively, after adjusting for confounding variables. Considering the associated cardiovascular risk, calcium supplementation for osteoporosis treatment should be administered cautiously.</description><subject>Age</subject><subject>Biomedical materials</subject><subject>Calcium</subject><subject>Calcium, Dietary</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cerebral infarction</subject><subject>Comorbidity</subject><subject>Confidence intervals</subject><subject>Death</subject><subject>Diet therapy</subject><subject>Dietary Supplements</subject><subject>Health aspects</subject><subject>Health hazards</subject><subject>Health insurance</subject><subject>Health risks</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Ischemia</subject><subject>Ischemic Stroke</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - complications</subject><subject>National Health Programs</subject><subject>Osteoporosis</subject><subject>Population</subject><subject>Rank tests</subject><subject>Regression analysis</subject><subject>Republic of Korea - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk Factors</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Stroke - complications</subject><issn>2072-6643</issn><issn>2072-6643</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNptkt9rFDEQxxdRbKl98Q-QgC8i3Zpsdje7PhSOq7XFqtBTfAxzyWwvNZucye7B_Rf-yc3a2h9iEpgh-cx3mMlk2UtGDzlv6Ts3spIVRcWbJ9luQUWR13XJnz7wd7L9GK_otAQVNX-e7fBKlFVRN7vZ7zlYZcaeLMb12mKPboDBeHdALkz8SXxH5hC08RuIarQQyLGJCBHjAQGnyWcfBrBm2L4nM3KBYPMfPlhNFsOot1P0sELyyQcER778EQZLThM3rMiZi2MAp5AsMGxMsscwwIvsWQc24v6t3cu-n3z4Nj_Nz79-PJvPznNVCj7kXcN5jaritAOmsaRVrbUWHQOgrNGaVtguBRccWa0KRnHZtFXLW6Ww5Yxqvpcd3eiux2WPWqXCA1i5DqaHsJUejHz84sxKXvqNbAtOq7ZOAm9uBYL_NWIcZG-iQmvBoR-jTO1llIt0Evr6H_TKjyG1YqJE29CmLst76hIsSuM6n_KqSVTORNGWRfq7Ke3hf6i0NfZGeYedSfePAt7eBKjgYwzY3dXIqJxGSN6PUIJfPezKHfp3YPg126PA-g</recordid><startdate>20220618</startdate><enddate>20220618</enddate><creator>Park, Jae-Min</creator><creator>Lee, Bora</creator><creator>Kim, Young-Sang</creator><creator>Hong, Kyung-Won</creator><creator>Park, Yon Chul</creator><creator>Shin, Dong Hyeok</creator><creator>Kim, Yonghwan</creator><creator>Han, Kunhee</creator><creator>Kim, Kwangyoon</creator><creator>Shin, Junghwa</creator><creator>Kim, Mina</creator><creator>Kim, Bom-Taeck</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9965-675X</orcidid><orcidid>https://orcid.org/0000-0001-8873-8832</orcidid><orcidid>https://orcid.org/0000-0002-3137-4609</orcidid><orcidid>https://orcid.org/0000-0002-7397-5410</orcidid><orcidid>https://orcid.org/0000-0003-3180-4565</orcidid></search><sort><creationdate>20220618</creationdate><title>Calcium Supplementation, Risk of Cardiovascular Diseases, and Mortality: A Real-World Study of the Korean National Health Insurance Service Data</title><author>Park, Jae-Min ; Lee, Bora ; Kim, Young-Sang ; Hong, Kyung-Won ; Park, Yon Chul ; Shin, Dong Hyeok ; Kim, Yonghwan ; Han, Kunhee ; Kim, Kwangyoon ; Shin, Junghwa ; Kim, Mina ; Kim, Bom-Taeck</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c473t-f8336ec530fa1de4056ddd7f1aa018dd05e9b7373e16c210eb895939cce9310d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Age</topic><topic>Biomedical materials</topic><topic>Calcium</topic><topic>Calcium, Dietary</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cerebral infarction</topic><topic>Comorbidity</topic><topic>Confidence intervals</topic><topic>Death</topic><topic>Diet therapy</topic><topic>Dietary Supplements</topic><topic>Health aspects</topic><topic>Health hazards</topic><topic>Health insurance</topic><topic>Health risks</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Ischemia</topic><topic>Ischemic Stroke</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - complications</topic><topic>National Health Programs</topic><topic>Osteoporosis</topic><topic>Population</topic><topic>Rank tests</topic><topic>Regression analysis</topic><topic>Republic of Korea - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk Factors</topic><topic>Statistical analysis</topic><topic>Stroke</topic><topic>Stroke - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Jae-Min</creatorcontrib><creatorcontrib>Lee, Bora</creatorcontrib><creatorcontrib>Kim, Young-Sang</creatorcontrib><creatorcontrib>Hong, Kyung-Won</creatorcontrib><creatorcontrib>Park, Yon Chul</creatorcontrib><creatorcontrib>Shin, Dong Hyeok</creatorcontrib><creatorcontrib>Kim, Yonghwan</creatorcontrib><creatorcontrib>Han, Kunhee</creatorcontrib><creatorcontrib>Kim, Kwangyoon</creatorcontrib><creatorcontrib>Shin, Junghwa</creatorcontrib><creatorcontrib>Kim, Mina</creatorcontrib><creatorcontrib>Kim, Bom-Taeck</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Nutrients</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Jae-Min</au><au>Lee, Bora</au><au>Kim, Young-Sang</au><au>Hong, Kyung-Won</au><au>Park, Yon Chul</au><au>Shin, Dong Hyeok</au><au>Kim, Yonghwan</au><au>Han, Kunhee</au><au>Kim, Kwangyoon</au><au>Shin, Junghwa</au><au>Kim, Mina</au><au>Kim, Bom-Taeck</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Calcium Supplementation, Risk of Cardiovascular Diseases, and Mortality: A Real-World Study of the Korean National Health Insurance Service Data</atitle><jtitle>Nutrients</jtitle><addtitle>Nutrients</addtitle><date>2022-06-18</date><risdate>2022</risdate><volume>14</volume><issue>12</issue><spage>2538</spage><pages>2538-</pages><issn>2072-6643</issn><eissn>2072-6643</eissn><abstract>Few studies have investigated the effects of calcium supplementation on cardiovascular outcomes in individuals with low calcium intake in real-world settings. This study examined the association between calcium supplementation and cardiovascular outcomes in the Korean population in a real-world setting. This large retrospective cohort study included patients aged ≥45 years first prescribed calcium supplements in 2010. Age- and sex-matched controls were recruited among those who had no prescription for calcium supplements. Longitudinal data were collected on 31 December 2018. Kaplan−Meier estimation and Cox proportional hazard regression analysis were performed. The cumulative incidence of acute myocardial infarction, ischemic stroke, and death was significantly higher in the calcium supplementation group than in the control group (p < 0.05 by log-rank test). The calcium supplementation group had a significantly higher risk of myocardial infarction, ischemic stroke, and death than the control group. Compared to the control group, the hazard ratios (95% confidence intervals) of the incidence of myocardial infarction, stroke, and death in the supplementation group were 1.14 (1.03−1.27), 1.12 (1.05−1.20), and 1.40 (1.32−1.50), respectively, after adjusting for confounding variables. Considering the associated cardiovascular risk, calcium supplementation for osteoporosis treatment should be administered cautiously.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>35745268</pmid><doi>10.3390/nu14122538</doi><orcidid>https://orcid.org/0000-0002-9965-675X</orcidid><orcidid>https://orcid.org/0000-0001-8873-8832</orcidid><orcidid>https://orcid.org/0000-0002-3137-4609</orcidid><orcidid>https://orcid.org/0000-0002-7397-5410</orcidid><orcidid>https://orcid.org/0000-0003-3180-4565</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MDPI - Multidisciplinary Digital Publishing Institute; MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Age Biomedical materials Calcium Calcium, Dietary Cardiovascular diseases Cardiovascular Diseases - epidemiology Cardiovascular Diseases - etiology Cerebral infarction Comorbidity Confidence intervals Death Diet therapy Dietary Supplements Health aspects Health hazards Health insurance Health risks Heart attacks Humans Ischemia Ischemic Stroke Mortality Myocardial infarction Myocardial Infarction - complications National Health Programs Osteoporosis Population Rank tests Regression analysis Republic of Korea - epidemiology Retrospective Studies Risk Risk Factors Statistical analysis Stroke Stroke - complications |
| title | Calcium Supplementation, Risk of Cardiovascular Diseases, and Mortality: A Real-World Study of the Korean National Health Insurance Service Data |
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