Relationship between Low Bone Mineral Density and Fractures with Incident Cardiovascular Disease: A Systematic Review and Meta-analysis

Veronese, Nicola and Stubbs, Brendon and Crepaldi, Gaetano and Solmi, Marco and Cooper, Cyrus and Harvey, Nicholas and Reginster, Jean-Yves and Rizzoli, Renè and Civitelli, Roberto and Schofield, Patricia and Maggi, Stefania and Lamb, Sarah E. (2017) Relationship between Low Bone Mineral Density and Fractures with Incident Cardiovascular Disease: A Systematic Review and Meta-analysis. Journal of Bone and Mineral Research, 32 (5). pp. 1126-1135. ISSN 1523-4681

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Official URL: http://dx.doi.org/10.1002/jbmr.3089

Abstract

An increasing evidence base suggests that low bone mineral density (BMD) and fractures are associated with cardiovascular disease (CVD). We conducted a systematic review and meta-analysis summarizing the evidence of low BMD and fractures as risk factors for future CVD. Two independent authors searched major databases from inception to 1st August 2016 for longitudinal studies reporting data on CVD incidence (overall and specific CVD) and BMD status and fractures. The association between low BMD, fractures and CVD across longitudinal studies was explored by calculating pooled adjusted hazard ratios (HRs) ± 95% confidence intervals (CIs) with a random-effects meta-analysis. Twenty-eight studies (18 regarding BMD and 10 fractures) followed-up a total of 1,107,885 participants for a median of 5 years. Taking those with higher BMD as the reference, people with low BMD were at increased risk of developing CVD during follow-up (11 studies; HR = 1.33; 95%CI: 1.27-1.38; I2  = 53%), after adjusting for a median of 8 confounders. This finding was confirmed using a decrease in one standard deviation of baseline BMD (9 studies; HR = 1.16; 95%CI: 1.09-1.24; I2  = 69%). The presence of fractures at baseline was associated with an increased risk of developing CVD (HR = 1.20; 95%CI: 1.06-1.37; I2  = 91%). Regarding specific CVD, low BMD was associated with an increased risk of developing coronary artery disease, cerebrovascular conditions, and CVD associated death. Fractures at baseline was associated with an increased risk of cerebrovascular conditions and death due to CVD. In conclusion, low BMD and fractures are associated with a small, but significant increased risk of CVD risk and possibly death.

Item Type: Journal Article
Additional Information: This is the accepted version, which has been published in final form at: http://dx.doi.org/10.1002/jbmr.3089
Keywords: Cardiovascular disease, Osteoporosis
Faculty: ARCHIVED Faculty of Health, Social Care & Education (until September 2018)
Depositing User: Brendon Stubbs
Date Deposited: 14 Mar 2017 09:56
Last Modified: 22 Aug 2019 11:32
URI: http://arro.anglia.ac.uk/id/eprint/701552

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