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Cardiovascular disease (CVD) and osteoporosis share several common risk factors and underlying biological mechanisms, suggesting a potential link between cardiovascular health and fracture risk.
In postmenopausal females, higher 10-year cardiovascular risk predicts an increased risk of major osteoporotic and hip fractures.
Cardiovascular disease (CVD) and osteoporosis share several common risk factors and underlying biological mechanisms, suggesting a potential link between cardiovascular health and fracture risk. However, whether predicted cardiovascular risk can help identify postmenopausal women at greater risk of fractures remains uncertain. Rafeka Hossain et al. evaluated the association between the PREVENT 10-year CVD risk score and the incidence of clinical, major osteoporotic, and hip fractures in postmenopausal women.
A prospective analysis was conducted using data from 21,300 postmenopausal women enrolled in the Women's Health Initiative. Participants were stratified according to their 10-year PREVENT cardiovascular disease risk into low (<5.0%), borderline (5.0%–7.4%), intermediate (7.5%–19.9%), and high (≥20.0%) risk categories. Cox proportional hazards regression models were applied to evaluate the connection between cardiovascular risk categories and incident clinical fractures, major osteoporotic fractures, and hip fractures after adjusting for sociodemographic, lifestyle, and clinical factors. Additional analyses accounted for the competing risk of mortality.
The participants had a mean (standard deviation) age of 63.7 (7.3) years. During follow-up:
Distribution of PREVENT cardiovascular risk categories was:
Compared with women at low cardiovascular risk, those with intermediate and high cardiovascular risk had a higher risk of major osteoporotic fractures (HR 1.14 and 1.22, respectively) and hip fractures (HR 1.33 and 1.93, respectively). Although these associations were weakened after considering the competing risk of mortality, elevated CVD risk remained independently associated with an increased risk of fractures.
Increasing 10-year cardiovascular disease risk was associated with a higher incidence of major osteoporotic and hip fractures, supporting the integration of cardiovascular risk into fracture assessment.
The Lancet Regional Health
The association between 10-year cardiovascular risk and fracture incidence in postmenopausal women: a prospective analysis from the Women's Health Initiative
Rafeka Hossain et al.
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