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CaD TrialObservational Study All participantsNo Personal Supplements a Non-users ofCalcium +CalciumVitamin D PlaceboCaDPlaceboCaDSupplementsVitamin DOnly.

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Presentation on theme: "CaD TrialObservational Study All participantsNo Personal Supplements a Non-users ofCalcium +CalciumVitamin D PlaceboCaDPlaceboCaDSupplementsVitamin DOnly."— Presentation transcript:

1 CaD TrialObservational Study All participantsNo Personal Supplements a Non-users ofCalcium +CalciumVitamin D PlaceboCaDPlaceboCaDSupplementsVitamin DOnly Number of women 18,10618,1767584771823,56115,47659411914 HIP FRACTURE Cases 19917580682121585526 Age-adjusted incidence (%) b 0.200.170.200.160.140.150.130.18 TOTAL FRACTURE Cases 2158210287087231722344834290 Age-adjusted incidence (%) b 1.941.851.861.812.022.282.042.21 MYOCARDIAL INFARCTION Cases 3904111671934332107740 Age-adjusted incidence (%) b 0.340.37 0.420.280.190.180.29 CORONARY HEART DISEASE Cases 4754992112295452529550 Age-adjusted incidence (%) b 0.420.450.470.510.350.230.220.36 TOTAL HEART DISEASE Cases 136314056426211602762328132 Age-adjusted incidence (%) b 1.241.281.441.391.050.710.770.97 STROKE Cases 3773621621844712539138 Age-adjusted incidence (%) b 0.350.330.370.420.310.230.210.27 Age-adjusted annualized incidence rates in the WHI CaD trial and Observational Study

2 CaD TrialObservational Study All participants No Personal Supplements a Non-users ofCalcium +CalciumVitamin D PlaceboCaDPlaceboCaDSupplementsVitamin DOnly TOTAL CARDIOVASCULAR DISEASE Cases 1810183281384821871069440181 Age-adjusted incidence (%) b 1.691.701.861.941.451.011.041.34 COLORECTAL CANCER Cases 1541687766174 88359 Age-adjusted incidence (%) b 0.130.150.160.140.110.08 0.06 BREAST CANCER Cases 54652824920266551721060 Age-adjusted incidence (%) b 0.450.430.480.380.400.480.490.43 TOTAL INVASIVE CANCER Cases 1411136661755317011187474153 Age-adjusted incidence (%) b 1.211.161.281.111.071.111.12 DEATH Cases 8077443383311240674266119 Age-adjusted incidence (%) b 0.720.670.750.720.780.61 0.84 Age-adjusted annualized incidence rates in the WHI CaD trial and Observational Study (continued)

3 CaD TrialObservationalCombined Trial and OS Years since CaD initiation All ParticipantsNo Personal Supplements a StudyAll ParticipantsNo Personal Supplements a HR95% CIHR95% CIHR95% CIHR95% CIHR95% CI HIP FRACTURE < 20.750.44,1.261.120.52,2.421.410.44,4.570.810.49,1.311.150.58,2.30 2 - 51.010.73,1.401.000.61,1.651.220.71,2.101.030.77,1.391.040.68,1.57 > 50.820.61,1.120.620.38,1.000.840.66,1.070.780.59,1.030.650.44,0.98 Trend test b 0.96 0.13 0.14 0.43 0.02 HR in OS/HR in Trial c 1.090.78,1.541.280.82,1.98 Overall HR d 0.880.71, 1.080.860.62, 1.200.880.70, 1.11 TOTAL FRACTURE < 20.960.86,1.080.910.76,1.100.890.61,1.310.950.85,1.060.900.76,1.06 2 - 50.940.86,1.030.970.84,1.121.050.91,1.220.950.87,1.030.980.87,1.11 > 50.980.88,1.091.030.87,1.221.081.01,1.140.980.90,1.081.020.90,1.16 Trend test b 0.83 0.35 0.42 0.53 0.21 HR in OS/HR in Trial c 1.090.99,1.211.050.92,1.20 Overall HR d 0.960.90, 1.020.970.88, 1.071.071.01, 1.14 DEATH < 20.730.56,0.960.680.44,1.061.490.79,2.830.800.62,1.040.860.58,1.27 2 - 50.870.75,1.020.870.68,1.110.850.61,1.180.870.76,1.010.890.72,1.09 > 51.010.87,1.181.120.89,1.400.950.85,1.060.990.86,1.131.040.86,1.26 Trend test b 0.03 0.71 0.09 0.17 HR in OS/HR in Trial c 0.970.82,1.150.920.74,1.14 Overall HR d 0.910.83, 1.010.950.81, 1.110.950.85, 1.06 Hazard ratios and 95% confidence intervals for calcium plus vitamin D supplementation from the WHI CaD trial and the Observational Study according to years from supplement initiation: Fractures and Total Deaths

4 CaD TrialObservationalCombined Trial and OS Years since CaD initiation All ParticipantsNo Personal Supplements a StudyAll ParticipantsNo Personal Supplements a HR95% CIHR95% CIHR95% CIHR95% CIHR95% CI MYOCARDIAL INFARCTION < 21.190.89,1.591.300.86,1.970.560.14,2.271.150.87,1.511.210.82,1.78 2 - 50.970.78,1.211.040.74,1.471.040.66,1.631.000.82,1.231.110.82,1.49 > 51.010.80,1.291.060.74,1.500.890.73,1.081.000.80,1.241.050.78,1.41 Trend test b 0.46 0.49 0.94 0.49 0.54 HR in OS/HR in Trial c 0.900.69,1.180.850.61,1.18 Overall HR d 1.030.90, 1.191.110.90, 1.370.900.75, 1.09 CORONARY HEART DISEASE e < 21.100.85,1.431.020.69,1.490.490.12,2.001.070.83,1.380.970.67,1.38 2 - 50.960.79,1.181.060.78,1.451.000.66,1.631.000.83,1.201.100.84,1.44 > 51.050.85,1.301.020.75,1.400.880.74,1.051.030.85,1.251.020.78,1.33 Trend test b 0.87 0.97 0.88 0.93 HR in OS/HR in Trial c 0.860.67,1.100.860.64,1.16 Overall HR d 1.030.90, 1.171.030.85, 1.250.880.74, 1.04 TOTAL HEART DISEASE f < 21.050.90,1.211.000.80,1.240.860.50,1.461.040.90,1.200.990.81,1.21 2 - 51.000.89,1.121.050.88,1.260.930.73,1.171.020.91,1.131.050.90,1.23 > 51.040.91,1.190.980.81,1.200.870.79,0.971.020.91,1.150.990.84,1.16 Trend test b 0.96 0.91 0.83 0.88 0.91 HR in OS/HR in Trial c 0.860.75,0.990.820.74,1.05 Overall HR d 1.020.95, 1.111.020.91, 1.140.870.79, 0.96 Hazard ratios and 95% confidence intervals for calcium plus vitamin D supplementation from the WHI CaD trial and Observational Study according to years from supplement initiation: Cardiovascular Diseases

5 CaD TrialObservationalCombined Trial and OS Years since CaD initiation All ParticipantsNo Personal Supplements a StudyAll ParticipantsNo Personal Supplements a HR95% CIHR95% CIHR95% CIHR95% CIHR95% CI STROKE < 20.820.60,1.121.110.73,1.680.470.12,1.890.780.58,1.051.000.68,1.46 2 – 51.060.84,1.341.170.83,1.650.910.57,1.441.030.84,1.271.160.87,1.55 > 50.920.73,1.171.090.79,1.520.930.77,1.110.980.80.1.201.170.90,1.54 Trend test b 0.71 0.93 0.43 0.37 0.53 HR in OS/HR in Trial c 0.960.75,1.230.810.60,1.09 Overall HR d 0.950.82,1.101.120.90,1.390.920.77,1.09 TOTAL CARDIOVASCULAR DISEASE < 20.970.85,1.111.020.84,1.230.870.55,1.350.970.86,1.101.020.85,1.21 2 - 50.990.89,1.101.030.89,1.210.910.74,1.111.010.92,1.101.040.91,1.19 > 51.050.93,1.181.020.86,1.210.860.79,0.941.020.93,1.131.010.88,1.16 Trend test b 0.37 0.97 0.84 0.42 0.93 HR in OS/HR in Trial c 0.850.75,0.960.850.73,0.99 Overall HR d 1.000.94,1.071.030.93,1.130.860.79,0.94 Hazard ratios and 95% confidence intervals for calcium plus vitamin D supplementation from the WHI CaD trial and Observational Study according to years from supplement initiation: Cardiovascular Diseases (continued)

6 CaD TrialObservationalCombined Trial and OS Years since CaD initiation All ParticipantsNo Personal Supplements a StudyAll ParticipantsNo Personal Supplements a HR95% CIHR95% CIHR95% CIHR95% CIHR95% CI COLORECTAL CANCER < 20.890.57,1.380.710.35,1.440.940.23,3.870.920.60,1.400.750.39,1.45 2 - 51.000.71,1.410.750.45,1.240.800.39,1.651.020.74,1.410.780.50,1.21 > 51.300.88,1.920.990.56,1.770.830.60,1.141.230.87,1.740.900.56,1.45 Trend test b 0.19 0.44 0.96 0.26 0.57 HR in OS/HR in Trial d 0.690.45,1.070.940.55,1.59 Overall HR d 1.060.85, 1.320.810.58, 1.130.830.61, 1.12 BREAST CANCER < 21.000.79,1.270.980.68,1.420.900.44,1.830.970.78,1.220.880.64,1.22 2 - 50.980.82,1.180.750.56,1.001.050.78,1.410.950.81,1.120.750.59,0.95 > 50.890.72,1.110.730.52,1.021.141.00,1.300.950.80,1.140.800.62,1.02 Trend test b 0.45 0.26 0.42 0.89 0.87 HR in OS/HR in Trial c 1.180.96,1.451.421.09,1.84 Overall HR d 0.960.85, 1.080.800.66, 0.961.120.99, 1.28 TOTAL INVASIVE CANCER < 20.960.83,1.120.960.76,1.220.870.56,1.360.950.82,1.090.910.74,1.12 2 - 50.940.84,1.060.820.69,0.980.990.82,1.200.940.85.1.050.840.73,0.97 > 50.990.87,1.130.890.73,1.091.040.95,1.130.990.89,1.110.900.77,1.05 Trend test b 0.77 0.73 0.31 0.48 0.72 HR in OS/HR in Trial d 1.040.91,1.181.150.97,1.35 Overall HR d 0.960.89, 1.040.880.78, 0.981.030.95, 1.11 Hazard ratios and 95% confidence intervals for calcium plus vitamin D supplementation from the WHI CaD trial and Observational Study according to years from supplement initiation: Invasive Cancer

7 Duration of CaD Supplementation All ParticipantsNo Personal SupplementsAll ParticipantsNo Personal Supplements HR95% CIHR95% CIHR95% CIHR95% CI HIP FRACTURETOTAL FRACTURE < 20.620.33,1.150.880.32,2.430.950.83,1.080.870.70,1.06 2 - 50.830.50,1.370.660.28,1.520.900.79,1.030.910.73,1.13 > 50.730.44,1.230.240.07,0.840.980.82,1.160.950.71,1.27 Trend test a 0.740.120.890.61 Overall HR b 0.730.54, 1.000.550.32, 0.970.940.86, 1.020.900.78, 1.03 MYOCARDIAL INFARCTIONCORONARY HEART DISEASE < 21.230.90,1.691.370.86,2.181.210.90,1.621.140.74,1.76 2 - 51.070.78,1.491.350.81,2.261.010.74,1.361.260.78,2.01 > 50.820.55,1.210.780.43,1.410.880.61,1.260.820.47,1.41 Trend test a 0.120.17 0.40 Overall HR b 1.060.87, 1.291.180.88, 1.591.040.87, 1.251.080.82, 1.42 TOTAL HEART DISEASESTROKE < 21.060.89,1.251.050.82,1.34 0.810.57,1.141.010.63,1.64 2 - 51.010.85,1.191.000.77,1.31 1.190.85,1.671.730.99,3.01 > 51.040.84,1.300.920.66,1.290.880.57,1.360.920.48,1.76 Trend test a 0.870.560.600.96 Overall HR b 1.030.93, 1.151.000.86, 1.180.960.78, 1.191.180.86, 1.62 Hazard ratios and 95% confidence intervals for calcium and vitamin D supplementation in the WHI CaD trial according to duration of supplementation among women adherent to their assigned study pills

8 Duration of CaD Supplementation All ParticipantsNo Personal SupplementsAll ParticipantsNo Personal Supplements HR95% CIHR95% CIHR95% CIHR95% CI TOTAL CARDIOVASCULAR DISEASECOLORECTAL CANCER < 20.980.85,1.141.040.84,1.290.910.56,1.470.730.34,1.60 2 – 51.040.89,1.201.070.84,1.341.010.62,1.660.920.44,1.93 > 51.060.88,1.290.980.73,1.311.100.59,2.070.710.27,1.88 Trend test a 0.490.770.630.98 Overall HR b 1.020.93, 1.121.040.90, 1.190.990.73, 1.340.800.50, 1.27 BREAST CANCERTOTAL INVASIVE CANCER < 20.960.73,1.270.900.58,1.390.970.82,1.140.940.71,1.23 2 - 50.850.66,1.100.600.39,0.920.860.74,1.020.700.53,0.92 > 50.880.63,1.240.670.39,1.170.950.77,1.180.790.56,1.11 Trend test a 0.640.350.810.35 Overall HR b 0.900.76, 1.060.710.55, 0.930.920.83, 1.020.800.68, 0.95 DEATH < 20.780.57,1.080.690.41,1.16 2 - 50.810.63,1.040.820.54,1.26 > 51.060.80,1.411.020.65,1.59 Trend test a 0.140.26 Overall HR b 0.880.75, 1.030.850.65, 1.11 Hazard ratios and 95% confidence intervals for calcium and vitamin D supplementation in the WHI CaD trial according to duration of supplementation among women adherent to their assigned study pills (continued)


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