Higher total bone density may reduce odds for CVD in women
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Women with a bone mineral density greater than 1.085 g/cm2 may have less risk for cardiovascular disease than those with a lower BMD, according to study data published in Nutrition, Metabolism & Cardiovascular Diseases.
“Studies have partially elucidated the value of BMD in predicting CVD risk,” Defeng Pan, MD, of the department of cardiology at the Affiliated Hospital of Xuzhou Medical University in China, and colleagues wrote. “However, fewer studies have focused on total BMD and CVD in women, and relevant large-scale participant studies evaluating BMD levels for clinical intervention are lacking. Thus, we explored the relationship between total BMD and total CVD (as well as specific CVD) using the U.S. National Health and Nutrition Examination Survey database.”
Researchers extracted data from 13,707 women in NHANES (mean age, 46.53 years). Data on total BMD, lumbar spine and femoral neck BMD, and total bone mineral content were collected. Fracture and CVD outcomes were self-reported. Five CVD outcomes were included in the subanalysis: congestive heart failure, coronary heart disease, angina pectoris, myocardial infarction and stroke.
Of the study cohort, 7.5% reported having CVD. Researchers observed an inflection point for total BMD and CVD. The risk for CVD was flat for women with a total BMD of 1.085 g/cm2 and declined as total BMD increased.
Participants were placed into quartiles based on their total BMD, with the two highest quartiles including women with a BMD of 1.085 g/cm2 or higher. After adjusting for confounding variables, women in the two highest total BMD quartiles had lower odds for total CVD compared with women in the lowest quartile with a total BMD of 1.009 g/cm2 or less (P = .008). No associations were observed for lumbar spine BMD or femoral neck BMD. Women who reported never having a fracture were less likely to have total CVD compared with those who had a previous fracture (OR = 0.71; 95% CI, 0.56-0.91; P = .007).
For individual CVDs, women in the two highest total BMD quartiles had lower odds for angina pectoris (P = .049), MI (P = .071) and stroke (P = .036) compared with women in the lowest total BMD quartile. Additionally, women without a history of fracture had lower odds for angina pectoris (OR = 0.69; 95% CI, 0.48-0.99; P = .046), MI (OR = 0.68; 95% CI, 0.47-0.99; P = .047) and stroke (OR = 0.68; 95% CI, 0.47-0.98; P = .04) compared with those with a previous fracture.
In subgroup analysis, women younger than 60 years in the two highest total BMD quartiles had a reduced risk for CVD compared with those of the same age in the lowest quartile. Additionally, women without hypertension and who did not participate in any physical activity in the second-highest total BMD quartile had lower odds for CVD compared with those in the lowest quartile.
“Monitoring total BMD and intervening adequately and rapidly would be helpful to decrease the CVD risk in women,” the researchers wrote.
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