Response to: Rapid response by Diehl on 'Supplemental calcium and vitamin D and long-term mortality in aortic stenosis'

We appreciate the critical review of our study1 by Dr Diehl (https://heart.bmj.com/content/108/12/964.responses%23physician). The concern surrounding our caution towards unrestricted oral calcium supplementation is a reasonable one, certainly when considering the public reception of our claims and the effects that such reactions may have on those who are vulnerable to underlying bone disease. We agree that physicians and patients alike are prone to these impressions. We further acknowledge, as we note in the Limitations section, that the absence of specific dosages in our study serves as a pitfall in identifying any theoretically harmful threshold of supplementation or dose-dependent association with outcomes. It is for these reasons that we centre our message on the effects of supplementation on cardiovascular outcomes, and namely, on the lack of cardiovascular benefit of calcium supplementation in a specific cohort with mild to moderate aortic stenosis. Secondarily, we speculate on the pathophysiological...
Source: Heart - Category: Cardiology Authors: Tags: Correspondence Source Type: research