Acute Effects Of Oral Calcium Carbonate With And Without The Addition Of Omeprazole And Fiber Enriched Milk On Serum Calcium Concentrations In Postmenopausal Women

Introduction: In recent years, some studies have shown an increase in cardiovascular risk due to the use of calcium supplements in excess of the recommended doses. One hypothesis is that some calcium supplements lead to a more pronounced elevation of serum calcium concentrations. Objectives: The aim of this study was to evaluate the serum calcium responses after ingestion of calcium carbonate, with and without the prior use of omeprazole, and after ingestion of soluble fiber enriched milk (SFM). Method: Five postmenopausal women were evaluated in three phases. For each phase, the serum calcium responses were determined at 0h (baseline), 1h, 2h, 3h and 4h. After ingestion of 1200mg of calcium, both for the patients who received the calcium carbonate and for those who received SFM. The rise in serum calcium observed after ingestion of calcium carbonate with a calcium peak of 0.56 mg/dl (p=0.032), and it was higher when compared to SFM 0.26 mg/dl (p=0.284). There was no significant elevation of serum calcium after ingestion of SFM. Results: The calcium responses were negative after the administration of omeprazole in comparison with the use of calcium carbonate and SFM, reaching 7.06mg/dl vs 9.04mg/dl vs 9.12mg/dl at 0h, 5.30mg/dl vs 9. 32mg/dl vs 9.00mg/dl at 1hr, 5.52mg/dl vs 9.48mg/dl vs 9.32mg/dl at 2hr, 5.18mg/dl vs 9.48mg/dl vs 9.34mg/dl at, respectively. In conclusion, our data show that the same amount of SFM induced a lower serum calcium response when compared to calcium carbonate. Conclusion: The use of omeprazole significantly reduced the intestinal absorption of calcium carbonate

Primary results of the brazilian registry of atherothrombotic disease (NEAT)

Abstract There is limited contemporary prospective real-world evidence of patients with chronic arterial disease in Latin America. The Network to control atherothrombosis (NEAT) registry is a national prospective observational study of patients with known coronary (CAD) and/or peripheral arterial disease (PAD) in Brazil. A total of 2,005 patients were enrolled among 25 sites from September 2020 to March 2022. Patient characteristics, medications and laboratorial data were collected. Primary objective was to assess the proportion of patients who, at the initial visit, were in accordance with good medical practices (domains) for reducing cardiovascular risk in atherothrombotic disease. From the total of patients enrolled, 2 were excluded since they did not meet eligibility criteria. Among the 2,003 subjects included in the analysis, 55.6% had isolated CAD, 28.7% exclusive PAD and 15.7% had both diagnoses. Overall mean age was 66.3 (± 10.5) years and 65.7% were male patients. Regarding evidence-based therapies (EBTs), 4% were not using any antithrombotic drug and only 1.5% were using vascular dose of rivaroxaban (2.5 mg bid). Only 0.3% of the patients satisfied all the domains of secondary prevention, including prescription of EBTs and targets of body-mass index, blood pressure, LDL-cholesterol, and adherence of lifestyle recommendations. The main barrier for prescription of EBTs was medical judgement. Our findings highlight that the contemporary practice does not reflect a comprehensive approach for secondary prevention and had very low incorporation of new therapies in Brazil. Large-scale populational interventions addressing these gaps are warranted to improve the use of evidence-based therapies and reduce the burden of atherothrombotic disease. ClinicalTrials.gov NCT0467772