People with the bone-thinning disease osteoporosis
are at increased risk for having coronary artery disease
(CAD), in which plaque build-up starves the heart of its
blood supply, investigators in Michigan report. In fact,
osteoporosis is a stronger factor than some traditional
risk markers for CAD.
"A previous study showed that women with osteoporosis
have more strokes and cardiovascular events, such as congestive
heart failure and chest pain," lead author Dr. Pamela
A. Marcovitz stated. "Also, a radiologist had published
a study showing they have higher coronary calcium scores,
implying that they have more coronary disease as well."
"But no one had looked at catheterization results, which
is the gold standard, to sort out this issue." With catheterization,
doctors inject special contrast material into the body
to create an "angiogram" that allows direct visualization
of the coronary arteries to determine if blockage is present.
Marcovitz, from William Beaumont Hospital in Royal Oak,
and her associates identified 183 women and 26 men who
underwent bone testing and catheterization within the
same 12-month period between 1999 and 2002. Clinically
significant CAD was documented in more than half of the
patients.
Patients with CAD were more likely to have brittle bones,
the investigators report in the American Journal of Cardiology.
The association was even stronger for those with osteoporosis.
Moreover, after accounting for traditional risk factors,
osteoporosis remained a significant predictor of CAD:
patients with osteoporosis were nearly six times more
likely to have CAD than those without osteoporosis. Osteoporosis
was a stronger risk factor for CAD than high blood sugar
levels, high blood pressure, or a family history of early
CAD.
So how might osteoporosis lead to CAD? No one knows for
sure, but cells that cause breakdown of bones, known as
osteoclasts, have also been shown to stimulate calcium
build-up in arteries, which may contribute to plaque build-up.
The results suggest that "perhaps we should be screening
women with (brittle bones) for heart disease," Marcovitz
commented, "and maybe we should be treating (brittle bones)
more aggressively to see if CAD is improved."
SOURCE: American Journal of Cardiology, October 15, 2005.
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Reference
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November
24, 2005
