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Heart failure linked to thinner bones and fractures

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Heart failure is associated with a 30% increase in major fractures and could identify a high-risk population that may benefit from increased osteoporosis screening and treatment, according to a study in the Journal of Clinical Endocrinology & Metabolism.

“Our study demonstrates for the first time that heart failure and thinning bones go hand in hand,” study author Sumit Majumdar, MD, stated in an Endocrine Society press release. “Understanding the mechanism between heart failure and osteoporosis might lead to new treatments for both conditions.”

According to the study abstract, researchers designed a population-based cohort study that linked administrative databases to a clinical registry of individuals 50 years of age or older who had bone mineral density (BMD) testing performed from 1998 to 2009. Researchers collected data on comorbidities, osteoporosis risk factors, medications and BMD results, and identified any recent-onset heart failure prior to BMD testing, as well as any new fractures after heart failure.

The primary outcome of the study, according to the abstract, was time to major osteoporotic fractures.

In all, the cohort consisted of 45,509 adults, 1,841 (4%) of which displayed recent-onset heart failure. Those subjects who displayed heart failure were reportedly found to have sustained more previous fractures (21% vs. 13%) and lower total hip BMD than those who did not, the researchers noted in the study abstracted.

During the 5-year observational period, the researchers reportedly identified 2,703 fractures, with 10% of those with heart failure displaying major fractures compared to a 5% major fracture rate in those that did not have heart failure.

“Part of screening for osteoporosis should involve looking at chest X-rays of patients with heart failure,” Majumdar stated in the release. “Heart failure patients get a lot of X-rays and they often incidentally show many fractures of the spine that would automatically provide an indication of severe osteoporosis and need for treatment."

Reference:

• Majumdar SR, Ezekowitz JA, Lix LM, Leslie WD. Heart failure is a clinically and densitometrically independent risk factor for osteoporotic fractures: Population-based cohort study of 45,509 subjects. J Clin Endocrinol Metab. 2012. doi: 10.1210/jc.2011-3055.

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