The role of the calcium intake in the development of cardiovascular calcification

Abstract

Calcium is a mineral that is crucial for life, necessary for the completion of essential and fundamental functions. In the extracellular environment, calcium behaves as a major protein co-factor assuring the integrity of the plasma membrane. It is also the main ingredient of the inorganic part of bone (hydroxyapatite), ensuring bone strength in an important extent. Calcium is also essential for intracellular functions, such as muscle contractions and neural stimulation. It also operates as a significant intracellular second messenger, modifying various cellular processes, such as mitosis, gene expression, energy metabolism and cell death. Moreover, a recent study concluded that calcium ions act as key points in controlling cellular lipid homeostasis, suggesting that ERCa status is an important regulator of basic sensitivity of the sterol detection mechanism. Moreover, research studies suggest the correlation between calcium intake and small reductions of arterial hypertension. Keeping serum calcium within a certain range, through regulatory mechanisms, is vital to the completion of the above functions. It has been observed that adequate calcium intake is critical for skeletal health. Over the age of 50 years old, for both women and men, the Recommended Nutrient Intakes (RNI) are at least 1.000 mg of calcium and 800 IU of vitamin D per day. The combination of calcium and vitamin D supplementation is generally recommended for people receiving medication for osteoporosis treatment. According to the European guidelines for the Diagnosis and Treatment of Postmenopausal Osteoporosis, the dietary calcium intake is recommended. Supplemental calcium (SC) can be provided if people cannot meet their dietary needs. Abstract Calcium covers a wide range of body functions. Adequate calcium intake is critical for skeletal health. Dietary calcium intake is considered safe, while supplemental calcium raises concerns, regarding cardiovascular health. Calcium can be administered alone or in combination with vitamin D. Supplemental calcium can be provided if people cannot meet their dietary needs or as a prescription in patients receiving medication for osteoporosis. The last ten years, a major research debate has been ongoing, regarding the possible relationship between calcium intake and cardiovascular risk. Possible mechanisms have been investigated, concerning the possible effect of calcium supplementation on cardiovascular calcifications. Further analysis is needed regarding levels of calcium intake that could possibly promote calcifications. It is also significant to evaluate the effect of the duration of supplemental calcium administration and the possible protective effect of concomitant administration of vitamin D supplementation. Until there are clinical studies to address those hypotheses, the current recommendations include that calcium (dietary and supplemental) can be given safely, within normal limits, to all healthy people and patients, possibly excluding those with chronic kidney disease.