A recent meta-analysis has shown that calcium supplementation without co-administration of vitamin D may increase the risk of MI by nearly a third. Studies included in the meta-analysis were randomised, placebo controlled trials of calcium supplements (500 mg/day), with 100 or more participants. The mean age of trial participants had to be >40 years (actual mean age was 75 years) and the trial duration > 1 year. 'While remaining alert to the limitations of meta-analysis this data suggest that we should perhaps reassess our current approach to calcium supplements especially in patients at high risk or with established cardiovascular disease. Calcium supplements are routinely prescribed for, and taken by, patients either at risk of, or with, established osteoporosis and many of these are elderly women who may also be at high risk of cardiovascular disease.'