Cardiovascular Diseases and Risk of Hip Fracture

Sennerby, Ulf; Melhus, Håkan; Gedeborg, Rolf; Byberg, Liisa; Garmo, Hans; Ahlbom, Anders; Pedersen, Nancy L.; Michaëlsson, Karl

doi:10.1001/jama.2009.1463

Cited by 295 publications

(231 citation statements)

References 39 publications

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“…(7) In addition, the presence of coronary calcifications has been associated with a nonsignificant 8% lower lumbar spine BMD, (8) suggesting that there is an association between subclinical atherosclerosis and lower bone density in the elderly. Recently, it has been reported that cardiovascular disease (CVD), such as congestive heart failure and stroke, is associated with an increase in the risk of subsequent hip fracture, (9) providing further support for such a connection, even if the exact mechanism remains unclear.…”

Section: Introductionmentioning

confidence: 98%

Hip fracture and risk of acute myocardial infarction: A nationwide study

Chiang

Liu

Chen

et al. 2012

Journal of Bone and Mineral Research

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Osteoporotic fractures are associated with increased mortality risk. However, little data are available on the risk of acute myocardial infarction (AMI) after hip fracture. Therefore, we investigated whether hip fracture increased the risk of AMI in a large, nationwide cohort study. We obtained data from 8758 patients diagnosed with hip fracture from 2000 to 2009 and from 4 matched controls for each patient from the Longitudinal Health Insurance Database (LHID 2000), Taiwan. Controls were matched for age, sex, comorbid disorders, and enrollment date. All subjects were followed up from the date of enrollment until AMI, death, or the end of data collection (2009). Cox's regression model adjusted for age, sex, comorbid disorders, and medication was used to assess independent factors determining the risk of development of AMI. As expected, despite the matching, the hip fracture patients had more risk factors for AMI at baseline. A total of 8758 subjects with hip fractures and 35,032 controls were identified. Among these patients, 1183 (257 hip fracture patients and 926 controls) developed AMI during the median 3.2-year (interquartile range 1.4 to 5.8 years) follow-up period. Patients with hip fractures had a higher incidence of AMI occurrence when compared with controls (8.7/1000 person-years versus 6.82/1000 person-years). Multivariate analysis adjusted for baseline covariates indicated that hip fracture was associated with a greater risk for AMI development (hazard ratio [HR] ¼ 1.29; 95% confidence interval [CI] 1.12-1.48; p < 0.001). We conclude that hip fracture is independently associated with a higher risk of subsequent AMI. ß

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Section: Introductionmentioning

confidence: 98%

Hip fracture and risk of acute myocardial infarction: A nationwide study

Chiang

Liu

Chen

et al. 2012

Journal of Bone and Mineral Research

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“…22,24 By contrast, such association was not found in a study based on selfreported data on hypertension obtained using self-administered questionnaires. 34 Sennerby et al 35 compared postmenopausal women having sustained a hip fracture with controls from the same region.…”

Section: Association Between the Prevalent Cardiovascular Pathology Amentioning

confidence: 75%

“…22 In a study that was a part of the Rochester Epidemiology Project, myocardial infarction was associated with higher risk of all types of osteoporotic fracture. 23 In a large Danish study carried out in about 500 000 individuals using the data from the National Health Service, a trial fibrillation was associated with higher risk of the fracture of hip, distal forearm or spine during the first 3 years after the incident.…”

Section: Association Between the Prevalent Cardiovascular Pathology Amentioning

confidence: 99%

Association between cardiovascular diseases and osteoporosis—reappraisal

Szulc

2012

BoneKEy Reports

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Many studies published over the past 20 years show a significant positive association between cardiovascular diseases (CVD) and osteoporosis. This association is important because it concerns two major public health problems. The investigation of shared biomarkers (clinical, radiological, biochemical) may improve identification of subjects at high risk of both diseases. The investigation of shared pathophysiological mechanisms may help to understand the pathophysiology of these diseases and to establish new treatments that could be efficient in both diseases. Below, I have tried to analyze various groups of clinical studies to better understand the association between osteoporosis and CVD as well as discrepancies between the studies. My review is focused on the epidemiological studies of the general population, and I have not analyzed the association between bone and CVD in chronic renal failure. Association between Cardiovascular Diseases and Bone Mineral DensitySeveral studies showed that CVD and arterial calcification are associated with decreased bone mineral density (BMD), although findings vary according to skeletal site and gender. Severe abdominal aortic calcification (AAC) was associated with lower BMD at the spine and hip in older women, 1 at the hip and whole body (but not spine) in older women (but not men), 2 at the lumbar spine (but not femoral neck) in a cohort of men and women, 3 at the femoral neck in women 4 and at whole body and distal forearm (but not at the spine or hip) in older men. 5 Severe AAC was associated with lower trabecular volumetric BMD at the spine in postmenopausal women, 6 in peri-and postmenopausal black and white women, 7 and in men and women aged у 45 years. 8 In a group of siblings concordant for type 2 diabetes, severity of the coronary and aortic calcification was correlated negatively with spine volumetric BMD. 9 In other studies, the association between AAC severity and BMD was weak or non-significant. 10 -13 Limited data also suggest a weak but significant association between severe peripheral arterial disease (PAD) and lower BMD at the hip. 14 -16 Elevated diastolic (but not systolic) blood pressure was associated with lower BMD at the total body, trochanter and Ward ' s triangle in a small group of 47 men aged 24 to 77 years. 17 REVIEW Association between cardiovascular diseases and osteoporosis -reappraisal Pawel SzulcINSERM UMR 1033, Universit é de Lyon, H ô pital Edouard Herriot , Lyon , France .Positive association between cardiovascular diseases and osteoporosis is important because it concerns two major public health problems. Men and women with cardiovascular diseases (including severe abdominal aortic calcification (AAC) and peripheral arterial disease) tend to have lower areal and volumetric bone mineral density (BMD) as well as faster bone loss, although findings vary according to skeletal site. On one hand, severe forms of cardiovascular diseases (heart failure, myocardial infarction, hypertension, severe AAC) are associated with higher risk of osteop...

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“…In 2007, Sennerby et al showed that women with cardiovascular disease had a substantially increased risk of hip fracture, suggesting possible common pathologic pathways for osteoporotic fractures and cardiovascular diseases [32]. In addition, in a cohort of 31'936 Swedish twins born in followed up from the age of 50 years, the same authors reported that a diagnosis of cardiovascular disease was significantly associated with risk of subsequent hip fracture within the same individual and in his or her co-twin without index diagnosis [33]. In the present analysis, we report an increasing incidence of both major consecutive women and men aged 50 years and older and presenting to the emergency ward of participating hospitals with a fragility fracture [34], virtually all hip fractures, approximately half of proximal humerus fractures, one third of distal radius fractures, and one fourth of clinical spine fractures were hospitalized in Switzerland [3].…”

Section: Cost Of Hospitalizationsmentioning

confidence: 98%

Comparative trends in hospitalizations for osteoporotic fractures and other frequent diseases between 2000 and 2008

et al. 2011

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Mini-AbstractIn Switzerland, the number, incidence, and cost of acute hospitalizations for major osteoporotic fractures and major cardiovascular events increased in both women and men between 2000 and 2008, although the mean length of stay was significantly reduced. Similar trend patterns were observed for hip fractures and strokes (decrease) and non-hip fractures and acute myocardial infarctions (increase). Methods : Trends in the number, age-standardized incidence, mean length of stay and cost of hospitalized MOF (hip, clinical spine, distal radius, and proximal humerus), major cardiovascular events (MCE: acute myocardial infarction, stroke, heart failure), chronic obstructive pulmonary disease (COPD), and breast carcinoma were compared in women and men aged ≥45 years, based on data from the Swiss Federal Statistical Office hospital database and population statistics.Results : Between 2000 and 2008, the age-standardized incidence of acute hospitalizations for MOF increased by 3.4% in women and 0.3% in men. In both sexes, a significant decrease in hip fractures (-15.0% and -11.0%) was compensated by a concomitant, significant increase in non-hip fractures (+24.8% and +13.8%).Similarly, the incidence of acute hospitalizations for MCE increased by 4.4% in women and 8.2% in men, as an aggregated result from significantly increasing acute myocardial infarctions and significantly decreasing strokes. While the mean length of stay in the acute inpatient setting decreased almost linearly between year 2000 and 3 2008 in all indications, the inpatient costs increased significantly (p<0.001) for MOF (+30.1%, +42.7%) and MCE (+22.6%, +47.1%) in women and men, respectively. In women in 2008, the cost of acute hospitalizations was more than threefold higher for MOF than for COPD and breast cancer and 1.5 fold higher than for any MCE. In men it was comparable to that of COPD, acute myocardial infarction, and heart failure.Conclusions : In conclusion, between year 2000 and 2008, the burden of hospitalized osteoporotic fractures to the Swiss healthcare system has continued to increase in both sexes. In women, this burden was significantly higher than that of major cardiovascular events and the gap between both disease groups widened over time.

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Cardiovascular Diseases and Risk of Hip Fracture

Cited by 295 publications

References 39 publications

Hip fracture and risk of acute myocardial infarction: A nationwide study

Hip fracture and risk of acute myocardial infarction: A nationwide study

Association between cardiovascular diseases and osteoporosis—reappraisal

Comparative trends in hospitalizations for osteoporotic fractures and other frequent diseases between 2000 and 2008

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