Osteoporosis International

, Volume 19, Issue 8, pp 1161–1166 | Cite as

Progression of vascular calcifications is associated with greater bone loss and increased bone fractures

  • M. Naves
  • M. Rodríguez-García
  • J. B. Díaz-López
  • C. Gómez-Alonso
  • J. B. Cannata-Andía
Original Article



In this prospective study, we found a positive relationship between the prevalence of aortic calcifications and age. Aortic calcifications at baseline were positively associated with osteoporotic fractures. In addition, progression of aortic calcifications was also positively associated with the rate of decline in BMD at lumbar spine.


The aim of this study was to analyze the relationship between the progression of abdominal aortic calcification and osteoporosis in a Spanish cohort of men and women older than 50.


Men and women (n = 624) aged 50 and over underwent two lateral X-rays of thoracic and lumbar spine and a dual X-ray absorptiometry (DXA) study at lumbar spine and hip, and were followed during 4 years. Abdominal aortic calcifications were classified as absent, mild-moderate and severe.


There was a positive relationship between the prevalence of aortic calcifications and age. In both sexes, prevalent severe aortic calcifications were positively associated with prevalent osteoporotic fractures [odds ratio (OR) = 1.93 (1.02–3.65)]. The association was stronger when only vertebral fracture was considered [OR = 2.45 (1.23–4.87)]. In addition, progression of aortic calcifications showed a positive association with the rate of decline in bone mineral density (BMD) at lumbar spine.


Aortic calcifications at baseline were positively associated with osteoporotic fractures. The progression of aortic calcifications was also positively associated with the rate of decline in BMD at lumbar spine.


Aortic calcification BMD Osteoporotic fracture Progression of vascular calcifications 



This study has been partially supported by European Vertebral Osteoporosis Study (EVOS), European Community (1991–1993); by European Prospective Osteoporosis Study (EPOS), European Community BIOMED 93–95. BMHI - CT 092–0182. (1993–1997); by Fondo de Investigaciones Sanitarias (FIS 94/1901-E) and by Fundación Renal Iñigo Álvarez de Toledo (Spain).

Conflicts of interest



  1. 1.
    Wilson PW, Kauppila LI, O’Donnell CJ, Kiel DP, Hannan M, Polak JM, Cupples LA (2001) Abdominal aortic calcific deposits are an important predictor of vascular morbidity and mortality. Circulation 103(11):1529–1534PubMedGoogle Scholar
  2. 2.
    Cummings SR, Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319):1761–1767PubMedCrossRefGoogle Scholar
  3. 3.
    Witteman JC, Kok FJ, van Saase JL, Valkenburg HA (1986) Aortic calcification as a predictor of cardiovascular mortality. Lancet 2(8516):1120–1122PubMedCrossRefGoogle Scholar
  4. 4.
    Boukhris R, Becker KL (1972) Calcification of the aorta and osteoporosis. A roentgenographic study. Jama 219(10):1307–1311PubMedCrossRefGoogle Scholar
  5. 5.
    Banks LM, Lees B, MacSweeney JE, Stevenson JC (1994) Effect of degenerative spinal and aortic calcification on bone density measurements in post-menopausal women: links between osteoporosis and cardiovascular disease? Eur J Clin Invest 24(12):813–817PubMedCrossRefGoogle Scholar
  6. 6.
    Dent CE, Engelbrecht HE, Godfrey RC (1968) Osteoporosis of lumbar vertebrae and calcification of abdominal aorta in women living in Durban. Br Med J 4(623):76–79PubMedCrossRefGoogle Scholar
  7. 7.
    Jie KG, Bots ML, Vermeer C, Witteman JC, Grobbee DE (1996) Vitamin K status and bone mass in women with and without aortic atherosclerosis: a population-based study. Calcif Tissue Int 59(5):352–356PubMedCrossRefGoogle Scholar
  8. 8.
    Frye MA, Melton LJ, 3rd, Bryant SC, Fitzpatrick LA, Wahner HW, Schwartz RS, Riggs BL (1992) Osteoporosis and calcification of the aorta. Bone Miner 19(2):185–194PubMedCrossRefGoogle Scholar
  9. 9.
    Anderson JB, Barnett E, Nordin BE (1964) The relation between osteoporosis and aortic calcification. Br J Radiol 37:910–912PubMedGoogle Scholar
  10. 10.
    Vogt MT, San Valentin R, Forrest KY, Nevitt MC, Cauley JA (1997) Bone mineral density and aortic calcification: the Study of Osteoporotic Fractures. J Am Geriatr Soc 45(2):140–145PubMedGoogle Scholar
  11. 11.
    von der Recke P, Hansen MA, Hassager C (1999) The association between low bone mass at the menopause and cardiovascular mortality. Am J Med 106(3):273–278PubMedCrossRefGoogle Scholar
  12. 12.
    Browner WS, Pressman AR, Nevitt MC, Cauley JA, Cummings SR (1993) Association between low bone density and stroke in elderly women. The study of osteoporotic fractures. Stroke 24(7):940–946PubMedGoogle Scholar
  13. 13.
    Hak AE, Pols HA, van Hemert AM, Hofman A, Witteman JC (2000) Progression of aortic calcification is associated with metacarpal bone loss during menopause: a population-based longitudinal study. Arterioscler Thromb Vasc Biol 20(8):1926–1931PubMedGoogle Scholar
  14. 14.
    Kiel DP, Kauppila LI, Cupples LA, Hannan MT, O’Donnell CJ, Wilson PW (2001) Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study. Calcif Tissue Int 68(5):271–276PubMedCrossRefGoogle Scholar
  15. 15.
    Schulz E, Arfai K, Liu X, Sayre J, Gilsanz V (2004) Aortic calcification and the risk of osteoporosis and fractures. J Clin Endocrinol Metab 89(9):4246–4253PubMedCrossRefGoogle Scholar
  16. 16.
    O’Neill TW, Felsenberg D, Varlow J, Cooper C, Kanis JA, Silman AJ (1996) The prevalence of vertebral deformity in european men and women: the European Vertebral Osteoporosis Study. J Bone Miner Res 11(7):1010–1018PubMedCrossRefGoogle Scholar
  17. 17.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174PubMedCrossRefGoogle Scholar
  18. 18.
    McCloskey EV, Spector TD, Eyres KS, Fern ED, O’Rourke N, Vasikaran S, Kanis JA (1993) The assessment of vertebral deformity: a method for use in population studies and clinical trials. Osteoporos Int 3(3):138–147PubMedCrossRefGoogle Scholar
  19. 19.
    Roy DK, O’Neill TW, Finn JD, Lunt M, Silman AJ, Felsenberg D, Armbrecht G, Banzer D, Benevolenskaya LI, Bhalla A, Bruges Armas J, Cannata JB, Cooper C, Dequeker J, Diaz MN, Eastell R, Yershova OB, Felsch B, Gowin W, Havelka S, Hoszowski K, Ismail AA, Jajic I, Janott I, Johnell O, Kanis JA, Kragl G, Lopez Vaz A, Lorenc R, Lyritis G, Masaryk P, Matthis C, Miazgowski T, Gennari C, Pols HA, Poor G, Raspe HH, Reid DM, Reisinger W, Scheidt-Nave C, Stepan JJ, Todd CJ, Weber K, Woolf AD, Reeve J (2003) Determinants of incident vertebral fracture in men and women: results from the European Prospective Osteoporosis Study (EPOS). Osteoporos Int 14(1):19–26PubMedCrossRefGoogle Scholar
  20. 20.
    WHO (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Technical Report Series 843, GenevaGoogle Scholar
  21. 21.
    Gomez Alonso C (1996) Valores de la densidad mineral ósea (BMD) en columna lumbar y cadera de la población sana española. En: Nuevas fronteras en el estudio de la densidad osea en la población española. In Gómez Alonso C (ed.). Rhone Poulenc Rorer, Madrid, pp 73–94Google Scholar
  22. 22.
    Tanne D, Tenenbaum A, Shemesh J, Schwammenthal Y, Fisman EZ, Schwammenthal E, Adler Y (2006) Calcification of the thoracic aorta by spiral computed tomography among hypertensive patients: Associations and risk of ischemic cerebrovascular events. Int J CardiolGoogle Scholar
  23. 23.
    Aoyagi K, Ross PD, Orloff J, Davis JW, Katagiri H, Wasnich RD (2001) Low bone density is not associated with aortic calcification. Calcif Tissue Int 69(1):20–24PubMedCrossRefGoogle Scholar
  24. 24.
    Farhat GN, Cauley JA, Matthews KA, Newman AB, Johnston J, Mackey R, Edmundowicz D, Sutton-Tyrrell K (2006) Volumetric BMD and vascular calcification in middle-aged women: the Study of Women’s Health Across the Nation. J Bone Miner Res 21(12):1839–1846PubMedCrossRefGoogle Scholar
  25. 25.
    Magnus JH, Broussard DL (2005) Relationship between bone mineral density and myocardial infarction in US adults. Osteoporos Int 16(12):2053–2062PubMedCrossRefGoogle Scholar
  26. 26.
    Farhat GN, Newman AB, Sutton-Tyrrell K, Matthews KA, Boudreau R, Schwartz AV, Harris T, Tylavsky F, Visser M, Cauley JA (2007) The association of bone mineral density measures with incident cardiovascular disease in older adults. Osteoporos IntGoogle Scholar
  27. 27.
    Hofbauer LC, Brueck CC, Shanahan CM, Schoppet M, Dobnig H (2007) Vascular calcification and osteoporosis-from clinical observation towards molecular understanding. Osteoporos Int 18(3):251–259PubMedCrossRefGoogle Scholar
  28. 28.
    Cannata-Andia JB, Rodriguez-Garcia M, Carrillo-Lopez N, Naves-Diaz M, Diaz-Lopez B (2006) Vascular calcifications: pathogenesis, management, and impact on clinical outcomes. J Am Soc Nephrol 17(12 Suppl 3):S267–273PubMedCrossRefGoogle Scholar
  29. 29.
    Bagger YZ, Rasmussen HB, Alexandersen P, Werge T, Christiansen C, Tanko LB (2007) Links between cardiovascular disease and osteoporosis in postmenopausal women: serum lipids or atherosclerosis per se? Osteoporos Int 18(4):505–512PubMedCrossRefGoogle Scholar
  30. 30.
    Walsh CR, Cupples LA, Levy D, Kiel DP, Hannan M, Wilson PW, O’Donnell CJ (2002) Abdominal aortic calcific deposits are associated with increased risk for congestive heart failure: the Framingham Heart Study. Am Heart J 144(4):733–739PubMedGoogle Scholar
  31. 31.
    Reid IR, Evans MC, Ames R, Wattie DJ (1991) The influence of osteophytes and aortic calcification on spinal mineral density in postmenopausal women. J Clin Endocrinol Metab 72(6):1372–1374PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2007

Authors and Affiliations

  • M. Naves
    • 1
  • M. Rodríguez-García
    • 1
  • J. B. Díaz-López
    • 1
  • C. Gómez-Alonso
    • 1
  • J. B. Cannata-Andía
    • 1
    • 2
  1. 1.Bone and Mineral Research Unit, Instituto Reina Sofía de InvestigaciónHospital Universitario Central de Asturias, Universidad de OviedoOviedoSpain
  2. 2.Bone and Mineral Research Unit, Instituto Reina Sofía de investigaciónHospital Universitario Central de AsturiasOviedoSpain

Personalised recommendations