Alendronate use among hip fracture patients was associated with significant reductions in cardiovascular mortality, incident myocardial infarction, and stroke. The findings come from a retrospective cohort study, published in the Journal of Bone Mineral Research, that used a population-wide database managed by the Hong Kong Hospital Authority. 

To examine the relationship between cardiovascular events and alendronate use, the researchers followed patients newly diagnosed with hip fractures from 2005 to 2013, and followed them until November 2016. Outcomes were measured at 1, 3, 5, and 10 years. Of the 34,991 total patients identified, 4602 (13.2%) received osteoporosis treatments during follow-up. The 4594 patients who were treated were matched with 13,568 untreated patients. 

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The 1-year cardiovascular mortality hazard ratio (HR) for alendronate users was 0.33 (95% CI, 0.17 to 0.65) and 0.55 for incident myocardial infarction (95% CI, 0.34 to 0.89). There was marginally significant reduction in risk of stroke observed at 5 years (HR 0.82; 95% CI, 0.67 to 1.00; P= .049) and at 10 years (HR 0.83; 95% CI, 0.69 to 1.01; P= .065). The authors added that over time, the strength of the association was lower but still remained significant.

Multiple sensitivity analyses further validated the findings to be robust. “Our findings show that alendronate is potentially cardioprotective in hip fracture patients,” said Dr. Ching-Lung Cheung, University of Hong Kong, and co-study author. Further studies are warranted, concluded the authors, into various anti-osteoporosis medications to gain a greater understanding between the medications and risk of cardiovascular events. 

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