Bone Mineral Density and Incidence of Stroke

Abstract

Background and Purpose-The prospective link between osteoporosis and future risk of stroke requires evidence from large-scale population-based long-term studies. Methods-Calcaneum broadband ultrasound attenuation was measured in the Norfolk cohort of the European Prospective Investigation into Cancer-Norfolk between 1997 and 2000. Incident strokes were ascertained by hospital record linkage and death certificates in March 2009 and December 2011, respectively. A search of MEDLINE and EMBASE was performed to evaluate the relationship between bone mineral density and incident stroke. After data extraction of relevant studies, pooled risk of stroke was estimated using meta-analysis. Results-In 14 290 participants (mean follow-up of 9.3 years; total person-years 132 574), there were 599 incident strokes.Participants in the lowest 10% of the calcaneum broadband ultrasound attenuation distribution had an increased stroke risk (hazard ratio 1.41; 95% confidence intervals, 1.02-1.94) compared with those in the top 30% of the distribution after adjustments. A decrease of ~1 standard deviation in broadband ultrasound attenuation (20 db/MHz) was associated with a 17% increase in relative risk of stroke (95% confidence intervals, 5%-30%). Meta-analysis of 4 studies (25 760 participants, 1237 cases of stroke) found that for every decrease in 1 standard deviation in bone mineral density, there was an increased risk of incident stroke among women (pooled relative risk 1.22; 95% confidence intervals, 1.09-1.37; I 2 =0%, 3 studies) but not in men (pooled relative risk 1.05; 95% confidence intervals, 0.94-1.17; I 2 =0%, 2 studies). Conclusions-Bone mineral density predicts total stroke risk. The evidence is stronger in women with regard to the continuous relationship. (Stroke. 2014;45:373-382.)

Physical Activity, Bone Health, and Obesity in Peri-/Pre- and Postmenopausal Women: Results from the EPIC-Potsdam Study

“…Furthermore, Moayyeri et al observed a similar performance between BUA and DEXA measures in prediction of long-term fractures risk in the elderly [ 43 ]. Overall, these findings suggest that BUA can be used as a valid, inexpensive, easy, and quick alternative assessment tool for bone health, and most importantly, without radiation [ 1 , 44 ]. The os calcis is a weight-bearing bone [ 24 ].…”

Effects of weight training time on bone mineral density of patients with secondary osteoporosis after hemiplegia

“…Another study on osteoporosis revealed that low bone density in femoral neck and osteoporosis would result in increasing stroke risks and mortality (14). A prospective study by European researchers also showed that osteoporosis may directly increase the incidence of stroke (15). All of these studies have suggested that stroke and osteoporosis were in reciprocal causation.…”

Falls and Osteoporosis Post-Stroke

“…Low BMD has been associated with a higher stroke risk in later life, meaning the stroke patient might already be predisposed to a higher fracture risk for reasons that are not entirely understood, but may involve shared risk factors for vascular calcification [ 67 ]. What is clear, however, is that there is a rapid and substantial decline in BMD following an acute stroke, as is the case following spinal cord injury and as seen in astronauts [ 57 ].…”