A new, larger randomized trial just put vitamin K2 back in the spotlight for arterial calcification. Vitamin K2 activates Matrix Gla Protein (MGP), which helps inhibit the formation and growth of calcium crystals within the arterial wall. That makes it biologically plausible that vitamin K2 could slow coronary artery calcification. And in this new 2-year randomized trial, vitamin K2 MK-7 did exactly that: people supplementing with vitamin K2 experienced less progression of coronary artery calcification than those receiving placebo. That sounds great—but there’s an important catch. More coronary artery calcium is associated with greater cardiovascular disease risk, but calcified plaque itself is generally considered more stable than softer forms of plaque. So simply reducing calcification doesn’t automatically mean you’re reducing cardiovascular risk. The study did NOT measure soft plaque. This leaves open an important question: did vitamin K2 reduce the overall progression of atherosclerosis, or did it simply alter how much of the plaque became calcified? It also wasn’t designed to determine whether vitamin K2 reduces heart attacks or other cardiovascular events. So, this study moves me slightly more toward believing that higher-dose vitamin K2 MK-7 can slow arterial calcification—particularly in people who already have coronary artery disease—but I’m still not convinced that reducing calcification itself is necessarily beneficial. The evidence remains mixed, and what we really need is a large randomized trial examining vitamin K2 against actual cardiovascular events. 🔬 For Physionic Insiders, I’ve gone considerably deeper into vitamin K2—including vitamin K2 + vitamin D3, arterial stiffness, plaque type, and the long-term evidence relating vitamin K intake to cardiovascular disease. Physionic Insider membership is the first link in my bio. REFERENCES Vossen LM, et al. JAMA Cardiol. 2026. doi:10.1001/jamacardio.2026.1279. Budoff MJ, et al. Eur Heart J. 2018;39:2401–2408. doi:10.1093/eurheartj/ehy217.