Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis



To exploring the role of vitamin D or calcium supplementation in reducing all-cause mortality and cardiovascular outcomes.


The search was restricted to systematic reviews or metaanalyses published from January 1, 2010, to July 7, 2019. An additional search was performed to identify recently published randomized controlled trials (from January 1, 2015, to July 7, 2019). Homogeneous results from different studies were pooled using Revman 5.3 software.


Twenty-three studies involving 89,251 participants were ultimately included in this meta-analysis. No associations were observed between the supplementation and composite cardiovascular outcomes, consisting of all-cause mortality, cardiovascular mortality, myocardial infarction, and other MACEs.


Whether used alone or in combination, vitamin D and calcium supplementation do not exert meaningful effects on all-cause mortality, cardiovascular mortality, MACEs or MI among community-dwelling adults.

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Funding: This work was funded by Beijing «Double First-rate» Personnel Department-High-level-Scientific Research funding Project for Wangyong’s team [No. 1000041510165 (18–19)],the Nation Natural Science Foundation of China (No.81822049, 81673712), Fok Ying Tung Education Foundation (No. 151044), Beijing Nova program (Z171100001117028) and the National Key R&D Program of China (No. 2017YFC1700100, 2017YFC1700102). The funders had no role in the study design, data collection and analysis, the decision to publish, or the preparation of the manuscript.

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Contributors: Authors’ contributions: Funding acquisition, Wei Wang and Yong Wang; Methodology, Yili Zhang and Xu Wei; Project administration, Wei Wang and Yong Wang; Resources, Yili Zhang and Nannan Tan; Software, Yuan Li; Visualization, Yili Zhang and Yuan Li; Writing - original draft, Yili Zhang, Yuan Li, Junjie Liu and Xu Wei; Writing - review & editing, Nannan Tan, Jian Zhang, Huihui Zhao and Yong Wang.

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Correspondence to Wei Wang or Yong Wang.

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Conflict of Interest: The authors declare that they have no conflict of interest.

Ethical approval: This article does not contain any studies with human participants or animals performed by any of the authors.

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Zhang, Y., Li, Y., Liu, J. et al. Association of Vitamin D or Calcium Supplementation with Cardiovascular Outcomes and Mortality: A Meta-Analysis with Trial Sequential Analysis. J Nutr Health Aging 25, 263–270 (2021).

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Key words

  • Evidence-based medicine
  • cardiovascular
  • vitamin
  • prevention
  • meta-analysis