Drs Cox and McNabb are employees of and own stock in Eli Lilly and Company. Dr Geiger owns stock in Eli Lilly and Company. Dr Christiansen is the CEO of the Center for Clinical and Basic Research, serves as a consultant, and receives honoraria from every pharmaceutical company in the field of osteoporosis including Eli Lilly and Company. All other authors have no conflicts of interest.
Relationship Between Osteoporosis and Cardiovascular Disease in Postmenopausal Women†
Version of Record online: 18 JUL 2005
Copyright © 2005 ASBMR
Journal of Bone and Mineral Research
Volume 20, Issue 11, pages 1912–1920, November 2005
How to Cite
Tankó, L. B., Christiansen, C., Cox, D. A., Geiger, M. J., McNabb, M. A. and Cummings, S. R. (2005), Relationship Between Osteoporosis and Cardiovascular Disease in Postmenopausal Women. J Bone Miner Res, 20: 1912–1920. doi: 10.1359/JBMR.050711
- Issue online: 4 DEC 2009
- Version of Record online: 18 JUL 2005
- Manuscript Accepted: 13 JUL 2005
- Manuscript Revised: 27 JUN 2005
- Manuscript Received: 24 MAR 2005
- cardiovascular diseases;
- risk factors;
- postmenopausal women;
In the placebo group of the MORE study, including 2576 postmenopausal women (mean age, 66.5 years), the authors describe a strong linear association between the severity grade of osteoporosis (from low BMD to presence of severe vertebral fractures) and the future risk of cardiovascular events. Accordingly, treatment of postmenopausal osteoporosis should include consideration of measures to prevent adverse cardiovascular outcomes.
Introduction: Observations indicate an inverse association between BMD and the severity of peripheral atherosclerosis in postmenopausal women. The predictive value of osteoporosis and its different severity stages for the risk of acute cardiovascular events remains unknown.
Materials and Methods: Participants were 2576 women (mean age, 66.5 years) assigned to placebo and followed for 4 years in an osteoporosis treatment trial. Those with at least one vertebral fracture or total hip BMD T score ≤ −2.5 at baseline were defined as having osteoporosis, whereas those without vertebral fracture and total hip BMD T score between −2.5 and −1 were defined as having low bone mass. The primary outcome for these posthoc analyses was the incidence of adjudicated fatal or nonfatal cardiovascular events.
Results: After adjustment for potential confounders, women with osteoporosis had a 3.9-fold (95% CI, 2.0–7.7; p < 0.001) increased risk for cardiovascular events compared with women with low bone mass. Under the same boundaries, a total hip BMD T score ≤ −2.5 versus a T score between −2.5 and −1 was associated with a 2.1-fold (95% CI, 1.2–3.6; p < 0.01) increase in risk, whereas presence of at least one vertebral fracture versus no vertebral fracture at baseline was associated with a 3.0-fold (95% CI, 1.8–5.1; p < 0.001) increase in risk. The risk of cardiovascular events increased incrementally with the number and increasing severity of baseline vertebral fractures (both p < 0.001).
Conclusions: Postmenopausal women with osteoporosis are at an increased risk for cardiovascular events that is proportional to the severity of osteoporosis at the time of the diagnosis. Treatment of postmenopausal osteoporosis should include consideration of measures to prevent cardiovascular outcomes.