Heart Failure Tied to Increased Osteoporotic Fracture Risk

Adults with heart failure have an increased risk of major osteoporotic fractures, independent of traditional risk factors and bone mineral density (BMD), according to a study published online Jan. 18 in the Journal of Clinical Endocrinology & Metabolism.

To investigate whether heart failure is associated with an increased risk of major osteoporotic fractures, independent of BMD, Sumit R. Majumdar, M.D., M.P.H., from the University of Alberta in Edmonton, Canada, and colleagues conducted a population-based study of 45,509 adults, aged 50 years and older, who underwent BMD testing from 1998 to 2009.

The researchers found that 4 percent of the adults had recent-onset heart failure; and compared with individuals without heart failure, they were significantly older (74 versus 66 years), had more previous fractures (21 versus 13 percent), and lower total hip BMD (T-score, −1.3 versus −0.9). Over a five-year observation period, there were 2,703 incident fractures. Ten percent of individuals with heart failure, and 5 percent of those without, had incident major fractures (unadjusted hazard ratio [HR], 2.45; 95 percent confidence interval [CI], 2.11 to 2.85). After adjusting for osteoporosis risk factors, comorbidities, and medications, the association was attenuated but not eliminated (HR, 1.33; 95 percent CI, 1.11 to 1.60), and the association remained after further adjustment for total hip BMD (HR, 1.28; 95 percent CI, 1.06 to 1.53).

"Heart failure is associated with a 30 percent increase in major fractures that is independent of traditional risk factors and BMD and it also identifies a high-risk population that may benefit from increased screening and treatment for osteoporosis," the authors write.

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