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Calcium Supplements May Increase Heart Disease Risk
Results could be tied to inadequate vitamin D.
C
alcium supplements, com
monly taken by older
adults to ward off osteo
porosis, may increase the risk of
heart attack. An international
team of researchers examined data
from 11 studies covering around
12,000 people who took calcium
supplements without vitamin D.
In all of the studies, people older
than 40 years took supplements
with calcium doses of 500 mg or
higher daily. Compared with those
who took a placebo, people who
took calcium had a 31% higher
risk of heart attack. There were
also slightly higher, nonsignificant
increases in the risk of stroke and
death.
The increase in cardiovas
cular risk is modest, but "the
widespread use of calcium supple
ments means that even a small
increase in incidence of cardio
vascular disease could translate
into a large burden of disease in
the population,'' write the au
thors. Although many people take
calcium supplements to prevent
osteoporosis, these supplements
only marginally reduce the risk of
bone fractures-by about 10%.
"Maintaining a healthy weight,
being physically active, not smok
ing, and having bone density mea
sured are other important aspects
of osteoporosis management,''
author Ian R. Reid told AJN.
Dee Sandquist, a spokesper
son for the American Dietetic
Association, advises people tak
ing calcium supplements to add
vitamin D to their regimens be-
cause other studies show no risk
of heart problems when calcium
and vitamin D are combined.
-Carol Potera
Bolland MJ, et al. BMJ 2010;341:c3691.
NewsCAPS
NewsCAPS
Consider the menstrual cycle when evaluating lipid lev
els. As estrogen levels rise during the menstrual cycle, so
does the level of high-density lipoprotein cholesterol, which
peaks at ovulation. And as estrogen peaks, low-density li
poprotein (LDL) cholesterol and triglyceride levels fall, ac
cording to a report in the September Journal of Clinical
Endocrinology and Metabolism. Hormone and blood lipid
levels were measured in 259 healthy women ages 18 to
44 years over two menstrual cycles. Approximately 14
measurements were taken in each woman, most of whom
were physically active; only 5% had baseline total choles
terol levels higher than 200 mg/dL (borderline high), but
20% reached 200 mg/dL at least once during the study.
Levels of total cholesterol, LDL cholesterol, and triglycerides
were lowest just before menstruation started. The results
suggest that variations in lipoprotein cholesterol levels "have
clinical implications regarding the appropriate timing of
lipoprotein cholesterol measurement during the [menstrual]
cycle," the authors write.
Updated classification criteria for rheumatoid arthritis.
The standard international criteria for classifying rheuma
toid arthritis, created in 1987, rely on symptoms of chronic
erosive disease, or disease that's already well established.
In an effort to identify and study patients who could benefit
from early treatment, members of the American College of
Rheumatology and the European League Against Rheuma
tism collaborated to develop a new approach that allows
for earlier identification of the disease. The 2010 criteria
are available online at http://bit.ly/9MVT3V.
A culturally based approach may help prevent HIV in
partners. Heterosexual African American couples in which
one partner is HIV-positive adopt safer sexual behaviors
after completing an intervention program that incorporates
Eban, a "traditional African concept meaning 'fence,' a
symbol of safety, security, and love within one's family" and
relationships. According to a report in the September 27
Archives of Internal Medicine, couples in the intervention
group reported more frequent condom use and fewer un
protected sexual acts, compared with control couples at
12-month follow-up. The eight-week Eban-based classes
taught skills to reduce sexual risk, including condom use,
communication, and monogamy. Couples in the control
group learned about general health behaviors like improv
ing diet and exercise and adherence to HIV medication
regimens. The results of this study suggest that the Eban
based intervention "may be scaled up to curb the mag
nitude and continued spread of HIV and other [sexually
transmitted diseases]," write the authors. 
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AJN  November 2010  Vol. 110, No. 11
ajnonline.com