Heart attack and stroke link to brittle bones, say researchers

Osteoporosis, often dubbed brittle bone disease, is common, particularly among women after the menopause. It is characterised by thinning and weakened bones and can increase the risk of fracture and disability.

Now researchers believe women with osteoporosis also have an increased risk of stroke and heart attacks.

The researchers from South Korea studied 12,681 women between the ages of 50 and 80 who were screened for osteoporosis over nine years.

Women with a formal osteoporosis diagnosis had a 79 per cent higher risk of heart disease than the general population based on hospital records, while thinning or weakened bones were also associated with an increased risk of heart attacks and stroke.

Previously published research indicates that people with osteoporosis often have atherosclerosis (artery hardening and narrowing), suggesting that both conditions may be linked.

Women have a higher risk of dying from cardiovascular disease (21 per cent) than men (15 per cent), but the way heart disease is predicted is more skewed towards men. Meaning there is a need to better identify women at risk of a heart attack or stroke.

Women are screened for osteoporosis using a DXA scan, and the researchers believe this assessment might provide an ideal opportunity to identify any potential associations between thinning bones and atherosclerosis, and those women most at risk of heart disease, without incurring any additional costs or further exposure to radiation.

The researchers reviewed the medical records of women aged 50 - 80 years who had had a DXA scan to check for osteoporosis at Seoul National University Bundang Hospital between 2005 and 2014.

After excluding those who already had heart disease and other serious illness at the time of the scan, the final analysis included 12,681 women whose health was tracked for an average of nine years, using national registry data.

In all, 468 women (around four per cent) had a heart attack or stroke during the monitoring period. Some 237 (two per cent) died.

Thinning/weakened bones, expressed as a low bone mineral density score at the lumbar spine, femoral neck, and hip, were independently associated with a heightened (16 per cent to 38 per cent) risk of heart attack or stroke after taking account of potentially influential factors, such as age, high blood pressure, high cholesterol, smoking, and a previous bone break.

And a formal diagnosis of osteoporosis was also independently associated with a 79 per cent higher risk of cardiovascular disease.

It's not clear exactly how osteoporosis and atherosclerosis might be linked, but long term inflammation and cumulative oxidative stress have key roles in both age-related bone loss and atherosclerosis, while sex hormones, particularly oestrogen, help regulate bone turnover and the vascular system, say the researchers.