People will have different degrees of calcium deficiency and even osteoporosis when they reach a certain age, especially the elderly, with less calcium ion intake and reduced gastrointestinal absorption capacity, they are more prone to osteoporosis, with osteoporosis, the bones become brittle, support, mobility and coordination functions weaken and degenerate, prone to falls and fractures, resulting in bedridden, loss of self-care ability, and over time, various This is one of the main reasons why the quality of life of patients decreases and the burden on families increases, so the concept of calcium supplementation to keep bones healthy has been deeply rooted in people’s minds. However, two large-scale studies from 2008 showed that the incidence of cardiovascular disease tended to increase in healthy menopausal women and older men who took calcium supplements, leading to a debate on whether calcium supplementation increased cardiovascular disease while reducing the risk of fracture; a meta-analysis of calcium supplementation and cardiovascular risk published in 2010 showed that the risk of myocardial infarction was 31% higher in those who took calcium supplements. However, some scholars subsequently scrutinized these trials and found that the investigators did not include cardiovascular events as an endpoint target, and some patients already had definite cardiovascular disease, and the pre-existing cardiovascular abnormalities were ignored in the statistical results, and these patients were treated as patients with new-onset cardiovascular disease after calcium supplementation, which resulted in increased atherosclerosis and cardiovascular disease after calcium supplementation. This leads to the wrong conclusion. To further clarify whether calcium supplementation is associated with atherosclerosis, several large-scale clinical studies have been conducted since 2012 to verify the causal relationship between them. For example, the Menopausal Women’s Health Study, in which participants took 1,000 mg of oral calcium and 400 IU of vitamin D daily, showed no significant increase in the risk of coronary heart disease, myocardial infarction, atherosclerosis, or death in women compared to controls who did not take calcium; the Mros Study, conducted in the United States in 2013, used elderly men who took oral The results of the Mros study conducted in the United States in 2013, in which older men were given either oral calcium supplements or calcium supplements combined with a high-calcium diet, showed that the above methods of calcium supplementation were not associated with cardiovascular disease. Carotid intima-media thickness and atheromatous plaque are the most common concerns and indicators to determine the degree of atherosclerosis, which can be obtained clinically by ultrasound and Doppler examination, which is simple, non-invasive and can be performed repeatedly. 2014, a comparative study was conducted using the causal relationship between calcium supplementation and carotid intima-media thickness plaque. The other group took oral placebo and finally concluded that there was no significant relationship between changes in carotid intima-media thickness and plaque in both groups with or without calcium, meaning that calcium supplementation did not aggravate the degree of carotid atherosclerosis. We look at the relationship between calcium and this lesion from the pathological process of atherosclerotic plaque formation: normal vessels first experience intima-media thickening, intima-media damage plaque formation, then plaque rupture, endothelial insufficiency, smooth muscle cell proliferation, platelet and glycoprotein aggregation, formation of non-occlusive wall-attached thrombus, at this time vascular proliferation, intact fibrous adventitious formation, calcium ion deposition, formation of calcified nodules, until extensive calcification, vascular sclerosis, until the formation of calcified nodules. From this process, we can see that calcium deposition is a response to intimal injury, a procedure of intimal repair after injury, which is commonly known as “scar formation”, so calcium deposition is the result of the response to intimal injury, not the cause. So how can I take calcium supplements more safely? As the saying goes, “everything in moderation is an overkill or overkill”. The natural rules of calcium supplementation are appropriate, appropriate amount and appropriate timing. Calcium carbonate is easy to obtain and cheap, so it can be considered first. But remember, calcium supplements are only for people with calcium deficiency or osteoporosis, and cannot be used for cardiovascular protection.