- A meta-analysis finds that heart failure may increase the risk of osteoporotic fracture, especially of the hip and humerus.
Why this matters
- The biological basis for increased risk may trace to (1) common risk factors, such as aging, menopause, smoking, and diabetes mellitus; and (2) some heart failure medications may trigger bone loss.
- Findings suggest that heart failure patients should be screened and treated for osteoporosis.
- Meta-analysis of 7 cohort studies involving approximately 180,000 participants, after search of PubMed, EMBASE, and Cochrane.
- Funding: None disclosed.
- Included studies were rated of high quality by the Newcastle-Ottawa Scale.
- Heart failure is associated with a 66% increased risk of fracture of any type (risk ratio [RR], 1.66; I2=94%; P=.008).
- Heart failure is associated with more than 3 times the risk of hip fracture (RR, 3.45; I2=95%; P<.0001>
- Heart failure is associated with a 91% increased risk of humerus fracture (RR, 1.91; I2=39%; P=.03).
- Heart failure is not associated with increased risk of vertebral (P=.11) and forearm (P=.69) fractures.
- High heterogeneity across studies.
- Small number of cohorts.