Heart health a good predictor of bone health

Osteoporosis and cardiovascular disease (CVD) are age-related diseases. Traditionally, these two conditions were considered unrelated and their coexistence was attributed to independent age-related processes. However, an increasing body of biological and epidemiological evidence has provided support for a link between the two conditions that cannot be explained by age alone. Shared risk factors, such as aging, smoking, low physical activity, and elevated body mass index (BMI), suggest that these disease states may have a shared pathophysiology. For example, women with osteoporosis have a 3.9-fold increased risk for experiencing a cardiovascular event

Atherosclerotic calcification and bone mineralization share a number of intriguing common features. It is now recognized that calcification of the arterial tissue is not merely a passive process of calcium phosphate precipitation or adsorption in end-stage atherosclerosis, but instead is a highly organized process that is regulated by mechanisms similar to those involved in bone mineralization. It is reported that patients with CVD have a higher risk of bone loss.  Low bone mineral density (BMD) has been related to increased cardiovascular mortality, cardiovascular morbidity, and subclinical measures of atherosclerosis in cross-sectional as well as longitudinal epidemiologic studies.

Osteoporosis patients have decreased conversion rate of osteoclasts to osteoblasts, which in turn lead to increased osteolysis and increased calcium ion concentration in blood circulation. High levels of calcium ions in the blood circulation deposit on the intima of the inner wall of the arterial vessel. Over time, atherosclerosis and calcification of the vessel wall including the coronary artery may occur, eventually leading to coronary heart disease. Osteoporosis prevalence was highest in those with severe hypertension, followed by moderate hypertension and mild hypertension. Moreover, renin-angiotensin-aldosterone system is also present in bone tissue to regulate the production and absorption of bone cells, and angiotensin I and angiotensin II can regulate the production and absorption of osteoclasts.

In recent years, a growing body of literature has revealed an association between CVD and osteoporosis. A study by the American Heart Association (AHA) also revealed that 38% of people with osteoporosis also had atrial fibrillation (AFib), an irregular heartbeat. AFib can increase the risk of stroke up to five times if left untreated. Additionally, the risk of osteoporosis is higher in people with type 1 diabetes, according to AHA. Of people sixty-five years old or older who have diabetes, 68% are likely to die from heart disease. Another study conducted amongst 1240 elderly Chinese patients showed that Senile osteoporosis is closely correlated with cardiovascular diseases and related risk factors, including hypertension, coronary heart disease as well as hyperlipidemia, and should be early prevented and treated. Similar findings were reported by a retrospective study of 428 patients where the results indicated that there is a close correlation between senile osteoporosis and hypertension, coronary heart disease and cerebral infarction. Osteoporosis can be used as a predictor of early screening for hypertension, coronary heart disease and cerebral infarction in the elderly population. In the same line, a research done on Chinese post-menopausal women also showed that postmenopausal women with osteoporosis had a higher prevalence of hypertension.

The potential relationship between these chronic conditions has important implications for the health of many individuals with (or at risk for) CVD and osteoporosis. Treating osteoporosis can thus help in treating heart conditions. Exercising, good diet and medications to enhance the bone strength of the body are few options. Activities ranging from brisk walking, yard work and climbing stairs to hiking or dancing help strengthen bones and the heart, but the exercise program should be included after discussing thoroughly with the physician if there is already an evidence of low BMD and heart disease. A common factor in those with low bone density is a lack of enough calcium and vitamin D. Therefore, a good diet is also an essential early intervention to stop the risk of developing further complications. Medications to improve bone strength like bisphosphonates, Hormone Replacement Therapy (HRT) can be prescribed for osteoporosis treatment.

It is clear that both CVD and osteoporosis are major health burdens affecting millions of people globally. A growing body of research supports a direct association between CVD and osteoporosis. There are numerous factors that may account for this relationship including risk factors that are common to both debilitating chronic conditions, and varied pathophysiological mechanisms. Both chronic conditions share similar modifiable risk factors (including physical inactivity) and such effective treatment strategies can be developed to address both diseases. Although CVD takes a higher toll on society in terms of premature mortality, morbidity rates, and health care costs, the importance of the prevention/treatment of osteoporosis (particularly in elderly women) cannot be overlooked. Habitual physical activity is an effective primary and secondary preventative strategy for both chronic conditions across the lifespan. Training-induced adaptations in endothelial function appear to be particularly important for the concurrent reductions in the risk of CVD and osteoporosis.

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REFERENCES:

Farhat GN, Cauley JA. The link between osteoporosis and cardiovascular disease. Clin Cases Miner Bone Metab. 2008;5(1):19-34.

Hu X, Ma S, Yang C, Wang W, Chen L. Relationship between senile osteoporosis and cardiovascular and cerebrovascular diseases. Exp Ther Med. 2019; 17(6):4417-4420.

Lian XL, Zhang YP, Li X, Jing LD, Cairang ZM, Gou JQ. Exploration on the relationship between the elderly osteoporosis and cardiovascular disease risk factors. Eur Rev Med Pharmacol Sci. 2017 Oct;21(19):4386-4390.

Chai H, Ge J, Li L, Li J, Ye Y. Hypertension is associated with osteoporosis: a case-control study in Chinese postmenopausal women. BMC Musculoskelet Disord. 2021;22(1):253. Published 2021 Mar 7.

Warburton DE, Nicol CW, Gatto SN, Bredin SS. Cardiovascular disease and osteoporosis: balancing risk management. Vasc Health Risk Manag. 2007;3(5):673-689.

West SL, O’Donnell E. Cardiovascular disease and bone loss—new research in identifying common disease pathophysiologies and predictors. AME Med J 2018;3:42.