Heart Failure Linked to Osteoporosis

Heart disease is known to be a major killer, but recent studies found a strange correlation between calcification of the arteries leading to heart attacks and strokes and lower bone mineral density indicating osteoporosis.

The common connection between these two serious diseases is a deficiency of vitamin D and vitamin K. Vitamin D is necessary for strong bones and helps in the absorption of calcium. Vitamin K is responsible for activating two proteins in the body: osteocalcin and matrix Gla protein (MGP). Osteocalcin is involved in the mineralization of bones while MGP protects soft tissue from calcification. Calcification of the arteries is a known clinical predictor of heart disease.

In clinical trials, supplements of vitamin K were found to decrease bone loss and increase bone mineral density as well as increasing the activation of osteocalcin. Once you understand the actions of these vitamins and proteins, it becomes clear why there may be a connection between heart disease and osteoporosis. It also makes sense for doctors examining chest x-rays for heart problems should look carefully at the patient’s bones for signs of fractures. Early diagnosis of osteoporosis means that effective treatment of the disease can begin at an early stage, avoiding fractures in the future.

In a study of 623 patients with a median age of 69, 12% of those with heart failure had spine compression fractures, a typical characteristic of osteoporosis. Of these 75 patients, just 11 were being treated for osteoporosis. The results were published by the American Heart Association journal Circulation: Heart Failure.
 
The study also showed that heart failure patients suffering from atrial fibrillation were twice as likely to have spinal fractures as those with normal heartbeat rhythms.

Study researcher Justin A. Ezekowitz, MD, an assistant professor at the Mazankowski Alberta Heart Institute in Edmonton, said it was important for doctors to examine carefully any chest x-rays of those with heart failure to see if there is any evidence of bone fractures, the first signs of osteoporosis. Patients can then be put on a suitable diet with exercise and osteoporosis medication if necessary. These procedures are known to reduce future fractures in osteoporosis sufferers by up to 50%. Spine compression fractures are common in osteoporosis sufferers and most are asymptomatic, thus escaping detection.

A further connection between chronic heart failure and osteoporosis is the hormone aldosterone. This hormone is made in the adrenal gland and helps regulate the balance of fluids, blood pressure and electrolytes. High levels of aldosterone have been linked in past studies to chronic heart failure, osteoporosis and atrial fibrillation. Scientists are now looking at whether treatment with an aldosterone antagonist could lower the occurrence of fractures as well as treating atrial fibrillation. Further studies will also consider whether atrial fibrillation should be considered a risk factor for osteoporosis.

 

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