Heart Failure Tied to Increased Osteoporotic Fracture Risk
(HealthDay News) – Adults with heart failure have an increased risk of major osteoporotic fractures, independent of traditional risk factors and bone mineral density (BMD), according to a study published online Jan. 18 in the Journal of Clinical Endocrinology & Metabolism.
To investigate whether heart failure is associated with an increased risk of major osteoporotic fractures, independent of BMD, Sumit R. Majumdar, M.D., M.P.H., from the University of Alberta in Edmonton, Canada, and colleagues conducted a population-based study of 45,509 adults, aged ≥50 years, who underwent BMD testing from 1998 to 2009.
The researchers found that 4 percent of the adults had recent-onset heart failure; and compared with individuals without heart failure, they were significantly older (74 vs. 66 years), had more previous fractures (21% vs. 13%), and lower total hip BMD (T-score, −1.3 versus −0.9). Over a five-year observation period, there were 2,703 incident fractures. Ten percent of individuals with heart failure, and 5% of those without, had incident major fractures (unadjusted hazard ratio [HR], 2.45; 95% CI 2.11 to 2.85). After adjusting for osteoporosis risk factors, comorbidities, and medications, the association was attenuated but not eliminated (HR, 1.33; 95% CI, 1.11 to 1.60), and the association remained after further adjustment for total hip BMD (HR, 1.28; 95% CI, 1.06 to 1.53).
"Heart failure is associated with a 30% increase in major fractures that is independent of traditional risk factors and BMD and it also identifies a high-risk population that may benefit from increased screening and treatment for osteoporosis," the authors write.