Resumen

DE CESPEDES-MONTEALEGRE, Carlos. The evolutionary approach: the lost dimension of medicine. Acta méd. costarric [online]. 2013, vol.55, n.1, pp.50-52. ISSN 0001-6002.

The results of a meta-analysis on the use of calcium supplements by women, “strongly suggest a relatively modest risk of myocardial infarction and stroke”. Although the authors acknowledge the inherent limitations in such studies, they recommend “a reassessment of the role of calcium supplements in the management of osteoporosis.” As possible underlying mechanisms, they suggest that a regulated vascular calcification process similar to osteogenesis occurs, and the possibility that excess calcium contributes to the risk of arterial thrombus formation. This essay is not intended to recommend changes in the clinical use of calcium supplements or to suggest a deeper analysis of the mentioned and other mechanisms. It seeks to analyze the problem according to the principles of Darwinian medicine. It is important to bear in mind that the evolutionary approach tries to explain the vulnerability to disease of Homo sapiens as a species. Although there is no doubt that individual susceptibilities to virtually all diseases may be present, with very few exceptions, the expectations of the Human Genome Project, in terms of examples and of the relevance of predisposing genes, have been far from fulfilled. It is reasonable to assume that the interest in this forgotten dimension of biomedicine -entirely ignored in the aforementioned article- could help to better understand the origin of medical problems such as the one related to the use of calcium supplements by women, and even to guide research and application of “personalized medicine”.

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