[Calcium supplementation and the risk of cardiovascular disease - Real apprehension or picking the spin?]


JULY 20, 2011

LAM KID - 2011;1(01)

[Some data shows that calcium supplementation, a basic intervention for treating osteoporosis in postmenopausal women, may increase the risk of atherosclerotic vascular disease. Coronary artery calcified plaque is a marker for atheromatous plaque burden and predicts future risk of cardiovascular events. However, the deposition of calcium into the vascular wall is due to an active mechanism, involving such genes and proteins which play role in bone metabolism. In this work the data about the cardiovascular side effect of calcium supplementation are reviewed. Also, I demonstrate studies with the conclusions that calcium supplements with or without vitamin D do not increase the risk of cardiovascular events, especially that of myocardial infarction.]



Further articles in this publication


[New findings in the cortical bone biology and its role in bone fractures]


[The authors surveyed the already known factors responsible for the osteoporotic bone fragility. Then the results of using modern imaging techniques (micro-CT, high-resolution peripheral computed quantitative tomograph - HR-pQCT) and advanced computer analytic methods (finite element analysis, FEA) are presented. These data - beyond the already known fracture risk factors (age, risk of falling, bone mineral density - BMD, and fine structure damage of trabecular bone) are stressing the importance of the (micro)damage of cortical bone as a fracture risk factor, which has been still underrated. The cortical thickening and increased porosity - verified on various population samples - are increasing the risk of fractures in certain subgroups of subjects having identical BMD values, even among those, who are considered only osteopenic by the earlier classification based on BMD values. Backed with modern software batteries, the new imaging techniques are expected to enter clinical application in the near future. Pharmacologic agents with stronger cortical effect are already available and research is continuing to find new drugs to use in the management of osteoporotic patients of high fracture risk.]


[FREEDOM study - The effect of denosumab in the prevention of bone fractures]

VALKUSZ Zsuzsanna, SZEKERES László


[Will the microarrays be used in medical routine practice?]

BÁLINT Bálint László


[FRISC: score system for risk assessment of osteoporotic fracture and immobilization in postmenopausal women]



[The concept of adherence and its significance in osteoporosis]


[Today, in relation to the economical aspects of medical therapies, the patterns of patients’ drug taking have come into focus. One of the important indicators is adherence, which consists of four different concepts concerning faithfulness to therapy: acceptance, concordance, persistance and compliance. In chronic diesases, medical therapy without a certain degree of adherence is no more useful than no therapy at all. A number of international clinical studies show that in osteoporosis, the therapy can only lead to a decrease in the number of fracture in case of sufficient adherence.]

All articles in the issue

Related contents

Lege Artis Medicinae



[Recent advances in the care of acute myocardial infarction have resulted in more patients surviving myocardial infarction than earlier. However, heart failure is a common complication in these patients, which in turn is associated with substantial mortality, primarily due to a remodelling of the left ventricle that already starts in an early stage of the myocardial infarction. The aim of this review article is to present the pathomechanism of this remodelling and to discuss related therapeutic options. Current guidelines recommend the use of an angiotensin- converting enzyme inhibitor combined with or followed by an angiotensin receptor blocker, a beta-blocker, and an aldosterone antagonist in post-infarction patients with concomitant heart failure.]

Hypertension and nephrology

[Importance, prevalence and therapy of vitamin D deficiency]

SZABÓ András

[Annual citations in the PubMed database on vitamin D were approximately 5000, this represents a doubling in the last decade and a 20% increase in the last year. There is renewed interest in vitamin D synthesis, metabolism and action. The two principal reasons for increased interest can be: 1. new knowledge regarding the nonhormonal, autocrine, and paracrine actions of 1,25-dihydroxylated vitamin D metabolites in man, 2. the worsening, worldwide trend to vitamin D insufficiency. Clinical vitamin D research in last years has confirmed the presence of a worldwide problem of vitamin D depletion, a problem that appears to be worsening. Largescale population based studies bear out long-held concerns that low serum 25(OH)D levels are associated with a number of adverse outcomes in the human musculoskeletal, innate immune, and cardiovascular systems. In fact, low vitamin D levels are significantly associated with all-cause mortality in the U.S. population and Hungary respectively. It is hypothesized that the global rise in incidence of obesity contributes to the worsening of the problem of vitamin D deficiency, amplifying adverse impacts on the host skeleton, immunoreactivity to microbes, and metabolic status. Finally, it should be remembered that treatment of vitamin D deficiency has two phases: restoration of 25(OH)D levels up to more than 30 ng/ml; and maintenance of the serum 25(OH)D level in that range. The present upper level (UL) of vitamin D intake that is deemed to be safe (2000 IU/day) must be re-evaluated considering data acquired over the past 15 years.]

Lege Artis Medicinae

[The atherosclerosis can not only be prevented, but also can be cured ]

MÁRK László

[The process of atherosclerosis nowadays plays an important role in the health care not just as a major cause of the most common cardiovascular diseases which lead to death, but also as a major factor in the loss of age-related elasticity in the blood vessels. Over the past two decades, large studies have shown that the treatment of high cholesterol levels can reduce the frequency of cardiovascular events and death and have confirmed the ability to reduce the already existing atherosclerotic plaque, which is almost unique in pharmacotherapy. Using lipid lowering therapy, if we do it properly, we can not only prevent vascular events, but can also cure atherosclerosis. Currently there are three drug groups (statins, ezetimibe and PCSK9- inhibitors), which have complete evidence that their use can reduce the number of cardiovascular events and plaque regression can be achieved. Despite many convincing clinical trials, lipid-lowering therapy is on the cardiovascular prevention palette in the just tolerated or forced applied category. In order to take advantage of its potentials at an appropriate level, as doctors, we have to approach to it by considering its importance. We should communicate to our patients that it’s about a life-long treatment, which not only can reduce the possibility of cardiovascular events, but also can slow down the aging process of the arteries. ]

Lege Artis Medicinae

[Experiences with rosuvastatine therapy]

MEZŐ Izabella

[A relative cardiovascular risk reduction of 25-35% has been reported in patients with high cardiovascular risk that have started statins directly after the cardiovascular events. A lot of patients fail to consistently take these medications as directed. In order to obtain further success, it is very important to improve the actual routine, especially because in the field of lipid-lowering we have new data and guidelines that strongly support our efforts in the right direc­tion. We report the results of our ten patients treated with rosuvastatin after myocardial infarction from our ALADDIN Study. In the period of six month of treatment with 40 mg rosuvastatin LDL-cholesterol decreased 55% (from 3.55±1.1 to 1.58±0.6 mmol/l, p<0.01), non-HDL-cholesterol decreased 52% (from 4.15±1.23 to 2.0±0.8 mmol/l, p<0.01), triglycerides -26% (from 1.63± 0.41 to 1.2±0.4 mmol/l) and hsCRP level decreased 61% (from 5.47±3.8 to 2.1±1.0 mg/l, p<0.01). The two years persistence in these patients were 100%. Our experience confirms that the daily use of a highly-efficient statin (rosuvastatin) has a beneficial effect on lipid parameters and also facilitates the attainment of target lipid levels and significant cardiovascular risk reduction. ]

Hypertension and nephrology

[Chronic kidney disease and atherosclerosis]


[Accelerated cardiovascular disease is a frequent complication of chronic kidney disease. Chronic kidney disease promotes hypertension and dyslipidaemia, which in turn can contribute to the progression of renal failure. Diabetic nephropathy is a leading cause of renal failure. Hypertension, dyslipidaemia and diabetes together are the major risk factors of the development of endothelial dysfunction and progression of atherosclerosis. Inflammatory mediators are often elevated and the renin-angiotensin system is frequently activated in chronic kidney disease. Promoters of calcification are increased and inhibitors are reduced, which favors vascular calcification, an important cause of vascular injury associated with end-stage renal disease. Accelerated atherosclerosis will then lead to increased prevalence of coronary artery disease, heart failure, stroke and peripheral arterial disease.]