Results from a large study of postmenopausal women show those at intermediate or high risk of developing cardiovascular disease also have higher risk of osteoporosis-related bone fractures than women at low risk for heart disease.
As reported in The Lancet Regional Health journal, after adjusting for various confounding factors women with intermediate and high cardiovascular risk, calculated using the PREVENT score, were 14% and 22% more likely to experience major osteoporotic fractures, respectively, than women at low risk.
Similarly, hip fracture risk was also linked with cardiovascular risk with women at intermediate and high risk of heart disease at 33% and 93% increased risk of hip fracture, respectively.
“The demonstrated association… highlights the shared pathophysiological mechanisms between cardiovascular disease and fracture and suggests that the PREVENT score may capture subclinical manifestations of cardiovascular disease that impact bone health,” write lead author Rafeka Hossain, a researcher at Tulane University, and colleagues.
“For endocrinologists managing patients with metabolic bone disease, these findings highlight the importance of considering cardiovascular disease risk factors when assessing fracture risk.”
The study included 21,300 women aged 64 years on average who were participating in the Women’s Health Initiative. They had low (25%), borderline (20%), intermediate (50%) or high (5%) cardiovascular risk, as measured using the PREVENT score.
Overall, 43% of the group experienced general fractures, 24% experienced a major osteoporotic fracture and 8% experienced hip fractures over 4.5–16 years of follow up.
Major osteoporotic fractures and hip fractures were linked to cardiovascular risk after correcting for multiple sociodemographic, lifestyle and clinical factors, although not fractures more generally.
The researchers think this link may at least in part be due to the reduction in estrogen seen after the menopause, which can impact both heart and bone health. Other factors like lifestyle also play a role.
“Many of the same factors that protect your heart—regular physical activity, a balanced diet rich in calcium and vitamin D, not smoking and managing conditions like diabetes and high blood pressure—also help protect your bones,” said Hossain in a press statement.
“If you’ve been told you have intermediate or high cardiovascular risk, particularly if you are a postmenopausal woman, it may be worthwhile to talk to your doctor about bone health screening, given the many effective treatments available that reduce fracture risk.”
