Relationships between vascular calcification, calcium metabolism, bone density, and fractures

Wang, Tom K.M.; Bolland, Mark J; Pelt, Niels C van; Horne, Anne; Mason, Barbara; Ames, Ruth; Grey, Andrew; Ruygrok, Peter; Gamble, Greg; Reid, Ian R.

doi:10.1002/jbmr.183

Cited by 86 publications

(75 citation statements)

References 51 publications

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“…Women with the highest CVD risk tion [28]. More recently Wang et al [5] reported that BMD in the 273 femur and total body but not the lumbar spine were decreased signif-…”

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confidence: 99%

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High osteoporotic fracture risk and CVD risk co-exist in postmenopausal women

Makovey

Macara

Chen

et al. 2013

Bone

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32 Results: Women with higher 10 year risk of major osteoporotic had significantly higher cardiovascular risk 33 (4.634% vs 8.36%, p =0.001). In multiple regression analysis, 5-year CVD risk was significantly associated with 34 the 10-year risk of having major osteoporotic (β=0.095, p=0.001) and hip (β =0.055, p=0.001) fracture.35 Women with the highest CVD risk were 5.4 times more likely to have higher risk of major osteoporotic fracture. 36 Conclusions: Fracture risk, determined by using a multiple risk factor algorithm such as FRAX, was positively 37 associated with higher cardiovascular risk determined by using the Framingham Risk Tool. Awareness regarding 38 these concurrent risk factors needs to be raised so that appropriate risk reduction can be implemented. 51Although BMD has shown a strong association with fracture risk, 52 most fractures occur in subjects with T-scores above −2.5, the 53 threshold typically used to define osteoporosis, which means that 54 relying solely on BMD will miss many patients at risk of fracture. Clin-55 ical risk factors are also associated with an increased probability of 64In the present study, we investigated the relationship between 65 bone and cardiovascular pathways by calculating fracture risk using 66 the FRAX [15][16][17][18] tool and comparing it to cardiovascular risk assessed 67 by the Framingham Heart Risk tool [9,10] in a large population of peri 68 and postmenopausal women. 69 Methods 70 Subjects 71Study subjects were female twins over 45 years, recruited as part of 72

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“…Women with the highest CVD risk tion [28]. More recently Wang et al [5] reported that BMD in the 273 femur and total body but not the lumbar spine were decreased signif-…”

mentioning

confidence: 99%

“…Inverse relationships 47 between bone mineral density (BMD) and calcified atherosclerotic 48 plaque have been reported in a number of population-based studies of 49 postmenopausal women [1][2][3][4][5]. A number of studies have also focused 50 on the relationship between plasma lipids and BMD [6][7][8].…”

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confidence: 99%

High osteoporotic fracture risk and CVD risk co-exist in postmenopausal women

Makovey

Macara

Chen

et al. 2013

Bone

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“…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.…”

Section: Association Between Cardiovascular Diseases and Bone Mineralmentioning

confidence: 99%

“…However, the adjustment for the measures of general health and frailty had a limited impact on these associations. Some, 1,4,5 but not all, 2,29,30 prospective studies showed that severe AAC is associated with higher risk of fragility fracture. This association was found both in men and in women, for various types of fracture (hip, vertebra, all osteoporotic fractures) and remained significant after adjustment for BMD.…”

Section: Association Between the Prevalent Cardiovascular Pathology Amentioning

confidence: 99%

“…1,5,6,25,35,38,43 By contrast, the results are less consistent in the studies in which mild forms of these pathologies were also taken into account. 2,10,11,21,41 More importantly, concomitant heart failure is a risk factor of mortality in hip fracture patients, whereas hip fracture confers a risk of mortality in patients with heart failure. 58 -60 The associations between CVD (especially AAC) and measures of osteoporosis (BMD, rate of bone loss, fracture incidence) are stronger in women than in men.…”

Section: Osteoporosis and Cvd -Consistency And Inconsistencymentioning

confidence: 99%

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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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Lack of Association of Oral Calcium Supplementation With Coronary Artery Calcification in Rheumatoid Arthritis

Geraldino‐Pardilla

Dhaduvai

Giles

et al. 2015

Arthritis & Rheumatology

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Objectives To investigate the association between oral calcium supplementation and coronary arterial calcification among rheumatoid arthritis (RA) patients without known cardiovascular disease (CVD). Methods This study was nested in a prospective cohort study of RA patients without known CVD. Daily supplemental calcium dose was ascertained from prescription and over-the-counter medications at baseline and visit 2 (median 20 months post-baseline). Coronary artery calcium (CAC), a measure of coronary atherosclerosis, was assessed by cardiac multi-detector row computed tomography at baseline and visit 3 (median 39 months post-baseline). The association of calcium supplementation with CAC was explored. Results Among the 145 RA patients studied, 42 (28%) took ≥1000mg/day of supplemental calcium at baseline. Forty-four (30%) and 50 (34%) had a CAC score >100 units at baseline and follow-up, respectively. Baseline CAC scores >100 units were significantly less frequent in the higher (≥1000mg/day) supplemental calcium group than in the lower dosed group (<1000mg/day) [OR 0.28 (95% CI 0.11-0.74)]; this remained significant after adjusting for relevant confounders [OR 0.30 (95% CI 0.09-0.93)]. Similarly, at the third study visit, CAC scores >100 units were less frequent in the higher vs. the lower supplemental calcium group [OR 0.41 (95% CI 0.18-0.95)]. When adjusted for relevant confounders, statistical significance was lost [OR 0.39 (95% CI 0.14-1.12)]. No gender interaction and no change in CAC score over time were appreciated. Conclusion Higher levels of oral calcium supplementation were not associated with an increased risk of coronary atherosclerosis as measured by CAC score in this RA cohort.

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Relationships between vascular calcification, calcium metabolism, bone density, and fractures

Cited by 86 publications

References 51 publications

High osteoporotic fracture risk and CVD risk co-exist in postmenopausal women

High osteoporotic fracture risk and CVD risk co-exist in postmenopausal women

Association between cardiovascular diseases and osteoporosis—reappraisal

Lack of Association of Oral Calcium Supplementation With Coronary Artery Calcification in Rheumatoid Arthritis

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