Cardiovascular health may be linked to risk for osteoporosis-related bone fractures

Key takeaways:

• Those with a high cardiovascular health score had lower odds for osteoporotic fracture.
• A higher score for certain Life’s Essential 8 metrics, like physical activity, also reduced the risk.

Better cardiovascular health significantly reduced the risk for bone fractures related to osteoporosis, according to results from a cross-sectional study.

The findings “underscore the importance of integrated public health strategies that target both cardiovascular and bone health to improve overall health outcomes,” the researchers wrote in Scientific Reports.

According to Jun Ou, from Central South University in China, and colleagues, osteoporotic fractures “represent a significant public health issue, especially among the aging population,” with around 2 million cases occur yearly in the U.S.

Currently, the U.S. Preventive Services Task Force recommends screening all women aged 65 years or older and postmenopausal women aged younger than 65 years for osteoporosis to prevent fractures, but evidence on screening for men is lacking.

The researchers noted that risk factors for cardiovascular health may have implications for bone health, whereas certain lifestyle factors that support cardiovascular health also support bone density and lower fracture risk.

They assessed the relationship between cardiovascular health and osteoporotic fracture risk among a sample of 17,606 adults aged 20 years or older (49.9% women) from the 2005 to 2018 National Health and Nutrition Examination Surveys.

Ou and colleagues measured cardiovascular health with the American Heart Association’s Life’s Essential 8 (LE8) score, which includes modifiable metrics like physical activity, tobacco use, BMI, lipid levels, blood glucose, diet, BP and sleep.

Researchers defined LE8 scores of below 50, 50 to 79 and 80 or above as low, moderate and high cardiovascular health, respectively.

The analysis’ main outcome of osteoporotic fracture, of which 12.3% of the sample was diagnosed with, was identified through self-reported data confirmed by a doctor.

People with higher cardiovascular health, who were likelier to be women, younger and have greater socioeconomic status, had a lower prevalence of osteoporotic fractures and diabetes vs. those lower cardiovascular health scores.

Ou and colleagues reported that each 1-point increase in the LE8 score corresponded with a 1% (OR=0.99; 95% CI, 0.98-0.99) decrease in the risk for osteoporotic fracture.

Those with moderate and high cardiovascular health levels had 22% (OR=0.78, 95% CI 0.7-0.87) and 34% (OR=0.66; 95% CI 0.56-0.79) lower odds of osteoporotic fractures, respectively, compared with those with low cardiovascular health levels.

The researchers wrote that this association appeared consistent across health-related, socioeconomic and demographic subgroups.

Certain LE8 scores also corresponded with lower osteoporotic fracture risk. Specifically, higher Dietary Approaches to Stop Hypertension diet scores were associated with a 4% (OR=0.96; 95% CI, 0.93-0.99) reduced risk, whereas higher physical activity lowered the risk by 5% (OR=0.95; 95% CI, 0.92-0.98).

Ou and colleagues highlighted a couple possible mechanisms behind the link between cardiovascular health and bone health.

For example, “hypertension has been identified as a risk factor for osteoporosis and fractures, possibly due to its effects on calcium excretion and bone mineral metabolism,” they wrote.

In contrast, “physical activity, which is a key component of both cardiovascular and bone health, directly influences bone density by applying mechanical stress to bone tissue, thereby stimulating bone formation,” they added.

Ou and colleagues ultimately concluded that the results underline “that not only do individual risk factors matter, but the overall state of cardiovascular health plays a crucial role in bone health outcomes.”