Bone mineral density and risk of heart failure in older adults

The cardiovascular health study

Raymond B. Fohtung, David L. Brown, William J H Koh, Traci M. Bartz, Laura D. Carbone, Roberto Civitelli, Phyllis K. Stein, Paulo H M Chaves, Bryan R. Kestenbaum, Jorge Kizer

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background-Despite increasing evidence of a common link between bone and heart health, the relationship between bone mineral density (BMD) and heart failure (HF) risk remains insufficiently studied. Methods and Results-We investigated whether BMD measured by dual-energy x-ray absorptiometry was associated with incident HF in an older cohort. Cox models were stratified by sex and interactions of BMD with race assessed. BMD was examined at the total hip and femoral neck separately, both continuously and by World Health Organization categories. Of 1250 participants, 442 (55% women) developed HF during the median follow-up of 10.5 years. In both black and nonblack women, neither total hip nor femoral neck BMD was significantly associated with HF; there was no significant interaction by race. In black and nonblack men, total hip, but not femoral neck, BMD was significantly associated with HF, with evidence of an interaction by race. In nonblack men, lower total hip BMD was associated with higher HF risk (hazard ratio, 1.13 [95% CI, 1.01-1.26] per 0.1 g/cm2 decrement), whereas in black men, lower total hip BMD was associated with lower HF risk (hazard ratio, 0.74 [95% CI, 0.59-0.94]). There were no black men with total hip osteoporosis. Among nonblack men, total hip osteoporosis was associated with higher HF risk (hazard ratio, 2.83 [95% CI, 1.39-5.74]) compared with normal BMD. Conclusions-Among older adults, lower total hip BMD was associated with higher HF risk in nonblack men but lower risk in black men, with no evidence of an association in women. Further research is needed to replicate these findings and to study potential underlying pathways.

Original languageEnglish (US)
Article numbere004344
JournalJournal of the American Heart Association
Volume6
Issue number3
DOIs
StatePublished - 2017

Fingerprint

Bone Density
Heart Failure
Health
Hip
Pelvic Bones
Femur Neck
Odds Ratio
Osteoporosis
Proportional Hazards Models
X-Rays
Bone and Bones
Research

Keywords

  • Bone mineral density
  • Heart failure
  • Osteoporosis
  • Race

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Bone mineral density and risk of heart failure in older adults : The cardiovascular health study. / Fohtung, Raymond B.; Brown, David L.; Koh, William J H; Bartz, Traci M.; Carbone, Laura D.; Civitelli, Roberto; Stein, Phyllis K.; Chaves, Paulo H M; Kestenbaum, Bryan R.; Kizer, Jorge.

In: Journal of the American Heart Association, Vol. 6, No. 3, e004344, 2017.

Research output: Contribution to journalArticle

Fohtung, RB, Brown, DL, Koh, WJH, Bartz, TM, Carbone, LD, Civitelli, R, Stein, PK, Chaves, PHM, Kestenbaum, BR & Kizer, J 2017, 'Bone mineral density and risk of heart failure in older adults: The cardiovascular health study', Journal of the American Heart Association, vol. 6, no. 3, e004344. https://doi.org/10.1161/JAHA.116.004344
Fohtung, Raymond B. ; Brown, David L. ; Koh, William J H ; Bartz, Traci M. ; Carbone, Laura D. ; Civitelli, Roberto ; Stein, Phyllis K. ; Chaves, Paulo H M ; Kestenbaum, Bryan R. ; Kizer, Jorge. / Bone mineral density and risk of heart failure in older adults : The cardiovascular health study. In: Journal of the American Heart Association. 2017 ; Vol. 6, No. 3.
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abstract = "Background-Despite increasing evidence of a common link between bone and heart health, the relationship between bone mineral density (BMD) and heart failure (HF) risk remains insufficiently studied. Methods and Results-We investigated whether BMD measured by dual-energy x-ray absorptiometry was associated with incident HF in an older cohort. Cox models were stratified by sex and interactions of BMD with race assessed. BMD was examined at the total hip and femoral neck separately, both continuously and by World Health Organization categories. Of 1250 participants, 442 (55{\%} women) developed HF during the median follow-up of 10.5 years. In both black and nonblack women, neither total hip nor femoral neck BMD was significantly associated with HF; there was no significant interaction by race. In black and nonblack men, total hip, but not femoral neck, BMD was significantly associated with HF, with evidence of an interaction by race. In nonblack men, lower total hip BMD was associated with higher HF risk (hazard ratio, 1.13 [95{\%} CI, 1.01-1.26] per 0.1 g/cm2 decrement), whereas in black men, lower total hip BMD was associated with lower HF risk (hazard ratio, 0.74 [95{\%} CI, 0.59-0.94]). There were no black men with total hip osteoporosis. Among nonblack men, total hip osteoporosis was associated with higher HF risk (hazard ratio, 2.83 [95{\%} CI, 1.39-5.74]) compared with normal BMD. Conclusions-Among older adults, lower total hip BMD was associated with higher HF risk in nonblack men but lower risk in black men, with no evidence of an association in women. Further research is needed to replicate these findings and to study potential underlying pathways.",
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AU - Koh, William J H

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AU - Carbone, Laura D.

AU - Civitelli, Roberto

AU - Stein, Phyllis K.

AU - Chaves, Paulo H M

AU - Kestenbaum, Bryan R.

AU - Kizer, Jorge

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AB - Background-Despite increasing evidence of a common link between bone and heart health, the relationship between bone mineral density (BMD) and heart failure (HF) risk remains insufficiently studied. Methods and Results-We investigated whether BMD measured by dual-energy x-ray absorptiometry was associated with incident HF in an older cohort. Cox models were stratified by sex and interactions of BMD with race assessed. BMD was examined at the total hip and femoral neck separately, both continuously and by World Health Organization categories. Of 1250 participants, 442 (55% women) developed HF during the median follow-up of 10.5 years. In both black and nonblack women, neither total hip nor femoral neck BMD was significantly associated with HF; there was no significant interaction by race. In black and nonblack men, total hip, but not femoral neck, BMD was significantly associated with HF, with evidence of an interaction by race. In nonblack men, lower total hip BMD was associated with higher HF risk (hazard ratio, 1.13 [95% CI, 1.01-1.26] per 0.1 g/cm2 decrement), whereas in black men, lower total hip BMD was associated with lower HF risk (hazard ratio, 0.74 [95% CI, 0.59-0.94]). There were no black men with total hip osteoporosis. Among nonblack men, total hip osteoporosis was associated with higher HF risk (hazard ratio, 2.83 [95% CI, 1.39-5.74]) compared with normal BMD. Conclusions-Among older adults, lower total hip BMD was associated with higher HF risk in nonblack men but lower risk in black men, with no evidence of an association in women. Further research is needed to replicate these findings and to study potential underlying pathways.

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