Osteoporotic fractures and heart failure in the community

Yariv Gerber, L. Joseph Melton, Susan A. Weston, Vronique L. Roger

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Purpose: Recent findings suggest a role for heart failure in the etiology of osteoporotic fractures, yet the temporal sequence of occurrence of the 2 conditions needs clarification. Methods: Using the Rochester Epidemiology Project, the authors conducted a 2-phase study: a case-control study compared osteoporotic fracture history among Olmsted County, Minnesota, residents newly diagnosed with heart failure in 1979-2002 with age- and sex-matched community controls without heart failure (961 pairs; mean age 76 years; 54% women). Both groups were then followed to July 2009 to evaluate their subsequent fracture risk in a cohort study. Results: Prior fractures were more frequent in heart failure cases than controls (23.1% vs. 18.8%, P = .02). The adjusted odds ratio (OR) for heart failure associated with prior fracture was 1.39 (95% confidence interval [CI], 1.07-1.81), mainly driven by hip fractures (OR 1.82; 95% CI, 1.25-2.66) with little or no association with other fractures. Over a mean follow-up of 7.5 years, 444 individuals developed subsequent osteoporotic fractures. The adjusted fracture risk was marginally elevated in heart failure patients compared with controls (hazard ratio [HR] 1.32; 95% CI, 0.98-1.79), again largely attributable to hip fractures (HR 1.58; 95% CI, 1.03-2.41). Conclusions: In this community, the association with fracture risk was about as strong before as after the diagnosis of heart failure and was nearly entirely attributable to hip fractures. Additional work is needed to identify common underlying mechanisms for heart failure and hip fracture, which may define prevention opportunities.

Original languageEnglish (US)
Pages (from-to)418-425
Number of pages8
JournalAmerican Journal of Medicine
Volume124
Issue number5
DOIs
StatePublished - May 2011

Keywords

  • Epidemiology
  • Fractures
  • Heart failure
  • Hip fracture
  • Osteoporosis
  • Prevention

ASJC Scopus subject areas

  • Medicine(all)

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