1. Long-Term Effect of Randomization to Calcium and Vitamin D Supplementation on Health in Older Women: Postintervention Follow-up of a Randomized Clinical Trial.
- Author
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Thomson, Cynthia A., Aragaki, Aaron K., Prentice, Ross L., Stefanick, Marcia L., Manson, JoAnn E., Wactawski-Wende, Jean, Watts, Nelson B., Van Horn, Linda, Shikany, James M., Rohan, Thomas E., Lane, Dorothy S., Wild, Robert A., Robles-Morales, Rogelio, Shadyab, Aladdin H., Saquib, Nazmus, and Cauley, Jane
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DIETARY supplements , *VITAMIN D , *OLDER women , *WOMEN'S health , *CHOLECALCIFEROL - Abstract
Although calcium and vitamin D supplementation may affect chronic disease in older women, evidence of long-term effects on health outcomes is limited. This post hoc analysis examines long-term postintervention outcomes with more than 20 years of follow-up of a 7-year randomized intervention trial of calcium and vitamin D. Visual Abstract. Long-Term Effect of Randomization to Calcium and Vitamin D Supplementation on Health in Older Women: Although calcium and vitamin D supplementation may affect chronic disease in older women, evidence of long-term effects on health outcomes is limited. This post hoc analysis examines long-term postintervention outcomes with more than 20 years of follow-up of a 7-year randomized intervention trial of calcium and vitamin D. Background: Although calcium and vitamin D (CaD) supplementation may affect chronic disease in older women, evidence of long-term effects on health outcomes is limited. Objective: To evaluate long-term health outcomes among postmenopausal women in the Women's Health Initiative CaD trial. Design: Post hoc analysis of long-term postintervention follow-up of the 7-year randomized intervention trial of CaD. (ClinicalTrials.gov: NCT00000611) Setting: A multicenter (n = 40) trial across the United States. Participants: 36 282 postmenopausal women with no history of breast or colorectal cancer. Intervention: Random 1:1 assignment to 1000 mg of calcium carbonate (400 mg of elemental calcium) with 400 IU of vitamin D 3 daily or placebo. Measurements: Incidence of colorectal, invasive breast, and total cancer; disease-specific and all-cause mortality; total cardiovascular disease (CVD); and hip fracture by randomization assignment (through December 2020). Analyses were stratified on personal supplement use. Results: For women randomly assigned to CaD versus placebo, a 7% reduction in cancer mortality was observed after a median cumulative follow-up of 22.3 years (1817 vs. 1943 deaths; hazard ratio [HR], 0.93 [95% CI, 0.87 to 0.99]), along with a 6% increase in CVD mortality (2621 vs. 2420 deaths; HR, 1.06 [CI, 1.01 to 1.12]). There was no overall effect on other measures, including all-cause mortality (7834 vs. 7748 deaths; HR, 1.00 [CI, 0.97 to 1.03]). Estimates for cancer incidence varied widely when stratified by whether participants reported supplement use before randomization, whereas estimates on mortality did not vary, except for CVD mortality. Limitation: Hip fracture and CVD outcomes were available on only a subset of participants, and effects of calcium versus vitamin D versus joint supplementation could not be disentangled. Conclusion: Calcium and vitamin D supplements seemed to reduce cancer mortality and increase CVD mortality after more than 20 years of follow-up among postmenopausal women, with no effect on all-cause mortality. Primary Funding Source: National Heart, Lung, and Blood Institute of the National Institutes of Health. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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