The Bone-Cardiovascular Axis: A Systematic Review of Prospective Studies: Journal Fur Mineralstoffwechsel

A. Tomaschitz, J. Rus-Machan, H. P. Dimai, G. Seiwald, H. Brussee, V. Weinrauch, N. Verheyen, A. Fahrleitner-Pammer, S. Pilz

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Both cardiovascular diseases and osteoporosis are related to an enormous economic burden and increased risk of morbidity and mortality. In the last years an intensive interplay between the bone and vasculature - the bone-vascular axis - and the co-occurrence of cardiovascular and bone diseases in various populations have been increasingly documented. The interdependence of heart and vascular physiology, skeletogenesis and bone mineralization is translated into clinically relevant associations between cardiovascular diseases and osteoporosis irrespective of kidney function or vascular calcification. Observational studies confirmed an independent relationship between bone loss, osteoporotic fractures and atherosclerotic diseases. In a systematic literature search (Medline, Pubmed) we identified 49 prospective observational studies which investigated the association between cardiovascular diseases, osteoporosis, bone mineral density and fracture risk. A great majority of these longitudinal analyses, which were however characterized by large heterogeneity in study population, duration of follow-up and considerations of potential confounders, revealed an increased risk of cardiovascular morbidity and mortality in women and men with low bone mineral density at different locations as well as in those with previous osteoporotic fractures. In addition, several studies noted a higher risk for the development of osteoporosis and osteoporotic fractures in patients with cardiovascular diseases. In particular, consistent associations were found between heart failure (7 studies), stroke (16 studies), peripheral arterial disease (3 studies) and both osteoporosis and fracture risk, respectively. Observational studies provided in this systemic review are limited in several fields similar to previous analyses, which identified currently accepted risk factors for osteoporosis and subsequent fracture risk. In view of the burden associated with cardiovascular and bone diseases the current evidence however indicates a potential benefit in screening for cardiovascular diseases and osteoporosis in respective risk groups.
Original languageEnglish
Pages (from-to)86-93
Number of pages8
JournalJ. Mineral.
Publication statusPublished - 2016

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