Cardiovascular disease and osteoporosis are major age-related causes of morbidity and premature death that occur among older adults. Emerging evidence suggests that calcium from bone is deposited in the arteries. This leads to calcification in valves and vessels, which is associated with a 3–4 fold higher risk of coronary heart disease. Calcium and vitamin D supplementation is frequently advised in older adults for the prevention of osteoporosis and to reduce the risk of fractures and falls. However, recent RCT's showed that individuals taking calcium and vitamin D were at higher risk of cardiovascular disease. The widespread use of vitamin D and calcium supplements, and the fortification of vitamin D in food products, underscores the need for further investigation. This lecture will give a brief overview of the current body of evidence and what to do recommend in daily practice.