Original Article

Osteoporosis International

, Volume 18, Issue 7, pp 999-1008

The association of bone mineral density measures with incident cardiovascular disease in older adults

  • G. N. FarhatAffiliated withDepartment of Epidemiology, Graduate School of Public Health, University of PittsburghDivision of Cancer Prevention and Population Science, University of Pittsburgh Email author 
  • , A. B. NewmanAffiliated withDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh
  • , K. Sutton-TyrrellAffiliated withDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh
  • , K. A. MatthewsAffiliated withDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh
  • , R. BoudreauAffiliated withDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh
  • , A. V. SchwartzAffiliated withDepartment of Epidemiology and Biostatistics, University of California
  • , T. HarrisAffiliated withLaboratory of Epidemiology, Demography, and Biometry, Intramural Research Program, National Institute on Aging
  • , F. TylavskyAffiliated withDepartment of Preventive Medicine, University of Tennessee Health Science Center
  • , M. VisserAffiliated withInstitute for Research in Extramural Medicine, VU Medical Center and Institute of Health Sciences, Vrije Universiteit
    • , J. A. CauleyAffiliated withDepartment of Epidemiology, Graduate School of Public Health, University of Pittsburgh
    • , for the Health ABC study

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Abstract

Summary

The associations of volumetric and areal bone mineral density (BMD) measures with incident cardiovascular disease (CVD) were studied in a biracial cohort of 2,310 older adults. BMD measures were inversely related to CVD in women and white men, independent of age and shared risk factors for osteoporosis and CVD.

Introduction

We investigated the associations of volumetric (vBMD) and areal (aBMD) bone mineral density measures with incident cardiovascular disease (CVD) in older adults enrolled in the Health, Aging, and Body Composition study.

Methods

The incidence of CVD was ascertained in 2,310 well-functioning white and black participants (42% black; 55% women), aged 68–80 years. aBMD measures of the hip were assessed using DXA. Spine trabecular, integral, and cortical vBMD measures were obtained using QCT.

Results

During an average follow-up of 5.4 years, 23% of men and 14% of women had incident CVD. Spine vBMD measures were inversely associated with incident CVD in white men [HR(integral)=1.39, 95% CI 1.03–1.87; HR(cortical)=1.38, 95% CI 1.03–1.84], but not in black men. In women, aBMD measures of the total hip (HR = 1.36, 95% CI 1.03–1.78), femoral neck (HR = 1.44, 95% CI 1.10–1.90), and trochanter (HR = 1.34, 95% CI 1.04–1.72) exhibited significant associations with CVD in blacks, but not in whites. All associations were independent of age and shared risk factors between osteoporosis and CVD, and were not explained by inflammatory cytokines or oxidized LDL.

Conclusion

Our results provide support for an inverse association between BMD and incident CVD. Further research should elucidate possible pathophysiological mechanisms linking osteoporosis and CVD.

Keywords

Areal BMD Incident cardiovascular disease Inflammatory cytokines Oxidized LDL Volumetric BMD