Table 2 Prospective studies investigating relationship low BMD and CV disease
Study | Study population (years follow-up) | Number of cases (% women) | Postmenopausal women | CV disease excluded | Mean age (years) | Race | Outcome osteoporosis | Outcome CV disease | Results # | Quality (x nee) |
|---|---|---|---|---|---|---|---|---|---|---|
Mussolino, 2007 [69] | Population-based (9) | 5,272 (NA) | NA | Yes | 60.9 to 69.4 | Caucasian (NA%), black and Mexican-American | BMD proximal femur by DXA | CV and stroke mortality by death certificates | Women: BMD and CV mortality RR: 1.26 (95% CI 0.88 to 1.80) BMD and stroke mortality: RR: 1.34 (95% CI 0.86 to 2.07) Men: BMD and CV mortality: RR: 1.05 (95% CI 0.79 to 1.39) BMD and stroke mortality: RR; 0.73 (95% CI 0.43 to 1.23) | 3 |
Farhat, 2007 [6] | Population-based (5.4) | 2,310 (55%) | Yes | Yes | 73.5 | Caucasian (58%) and black | BMD total hip, femoral neck and trochanter by DXA BMD spine by CT-scans | Incident CV disease by hospital records and death certificates | Women: BMD fem neck and incident CV disease: HR: 1.24 (95% CI 1.02 to 1.52) Men: BMD fem neck and incident CV disease: HR: 1.04 (95% CI 0.89 to 1.21) | 3 |
Tamaki, 2009 [75] | Population-based (10) | 609 (100%) | Yes (60%) | No | 55.9 | Japanese | BMD lumbar spine and total hip by DXA | IMT values | <10 YSM: IMT OP vs normal bone mass: 1.55 vs 1.19 (P < 0.05) ≥YSM: IMT OP vs normal bone mass: 1.53 vs 1.28 (P < 0.05) | 3 |
Browner, 1991 [5] | Population-based (2.8) | 9,704 (100%) | Yes | No | NA | Caucasian (99%) and Asian | BMD distal radius, prox radius and calcaneus by single photon absorptiometry | Overall mortality and CV mortality by death certificates | BMD and risk overall mortality: RR: 1.22 (95% CI 1.01 to 1.47) BMD and stroke mortality: RR: 1.75 (95% CI 1.15 to 2.65) BMD and CV mortality: RR: 1.17 (95% CI 0.92 to 1.51) | 3 |
Trone, 2007 [68] | Population-based (7.6) | 1,580 (60%) | Yes (NA %) | No | 71.9 | Caucasian | Prevalence vertebral fracture by lateral spine radiographs | Overall mortality by death certificates | Women: prevalent vertebral fracture and overall mortality: HR: 1.15 (95% CI 0.83 to 1.59) Men: prevalent vertebral fracture and overall mortality: HR: 0.98 (95% CI 0.55 to 1.46) | 3 |
Kado, 2000 [64] | Population-based (3.5) | 6,018 (100%) | Yes | No | 76.5 | Caucasian | BMD total hip by DXA | Overall and CV mortality by death certificates | BMD and overall mortality: RH: 1.3 (95% CI 1.1 to 1.4) BMD and CV mortality: RH: 1.3 (95% CI 1.0 to 1.9) | 4 |
Trivedi, 2001 [67] | Population-based (6.7) | 1,002 (0%) | No women included | No | 69.7 | NA | BMD total hip by DXA | Overall and CV mortality by death certificates | BMD and overall mortality: RR: 0.79 (95% CI 0.65 to 0.97) BMD and CV mortality: RR: 0.72 (95% CI 0.56 to 0.93) | 4 |
Tanko, 2005 [76] | Clinic-based (4) | 2,576 (100%) | Yes | No | 66.5 | NA | BMD lumbar spine and femoral neck by DXA | Incidence CV events self-reported and confirmed by primary documents | HR: 3.9 (95% CI 2.0 to 7.7) | 4 |
Pinheiro, 2006 [66] | Population-based (5) | 208 (100%) | Yes | No | 75.1 | Caucasian | BMD lumbar spine, femoral neck and trochanter by DXA | Overall and CV mortality by death certificates | BMD and overall mortality: HR: 1.44 (95% CI 1.06 to 2.21) BMD and CV mortality: HR: 1.28 (95% CI 1.08 to 2.26) | 4 |
Johansson, 1998 [7] | Population-based (7) | 1,468 (56%) | Yes | No | 74.0 | Caucasian | BMD calcaneus by DPA | Overall mortality by death certificates | Women: RR: 1.19 (95% CI 1.02 to 1.39) Men: RR: 1.23 (95% CI 1.10 to 1.41) | 4 |
Mussolino, 2003 [65] | Population-based (18.5) | 3,402 (NA) | NA | Yes | NA | Caucasian (87%) and black | BMD phalangeal by single photon absorption | Stroke mortality by death certificates | Women: RR: 1.01 (95% CI 0.86 to 1.19) Men: RR: 1.13 (95% CI 0.93 to 1.38) Blacks: RR : 0.93 (95% CI 0.72 to 1.21) | 4 |
Samelson, 2004 [70] | Population-based (30) | 2,059 (60%) | Yes (85,3-94%) | Yes | 60.2 | NA | Second MCA by radiogrammatry | Incidence coronary heart disease by hospital records and death certificates | Women: HR: 0.73 (95% CI 0.53 to 1.00) Men: HR: 1.14 (95% CI 0.84 to 1.56) | 4 |
Kiel, 2001 [77] | Population-based (25) | 554 (66%) | NA | No | 54.4 | NA | Second MCA by radiogrammetry | AC by radiograph of the lumbar spine | Women: Sign association % change in MCA and change AC index (P = 0.01) Men: No association % change MCA and change AC index (P = 0.50) | 4 |
Browner, 1993 [62] | Population-based (1.98) | 4,024 (100%) | Yes | Yes | NA | Caucasian | BMD distal radius and calcaneus by single photon absorptiometry | Incident strokes by hospital records and death certificates | HR: 1.31 (95% CI 1.03 to 1.67) | 5 |
Von der Recke, 1999 [8] | Clinic-based (17) | 1,063 (100%) | Yes | Yes | 50 and 70 | NA | BMD distal forearm by single photon absorptiometry with 125I source | CV mortality by death certificates, hospital records and autopsy reports | Early menopause: RR: 2.3 (95% CI 1.0 to 5.3) Late menopause: RR: 1.3 (95% CI 0.9 to 1.8) | 5 |
Silverman, 2004 [71] | Clinic-based (3) | 2,565 (100%) | Yes | No | 67 | Caucasian (95.8%) | Prevalence vertebral fracture by lateral spine radiographs | Incident CV event self-reported and confirmed by primary documents | CV event rate women with prevalent vertebral fracture vs no vertebral fracture: 15.1 vs 8.3 (P = 0.55) | 5 |
Varosy, 2003 [73] | Clinic-based (4.1) | 2,763 (100%) | Yes | Yes | NA | NA | Prevalent and incident skeletal fracture self-reported. Incident fractures were confirmed by radiological reports | Incident coronay event by hospital records | HR: 0.75 (95% CI 0.57 to 0.98) | 5 |
Gonzales-Macias, 2009 [63] | Clinic-based (3) | 5,201 (100%) | Yes | No | 72.3 | Caucasian | eBMD calcaneus by QUS | Overall and CV mortality by medical records | eBMD and overall mortality: HR: 1.19 (95% CI 0.97 to 1.45) eBMD and CV mortality: HR: 1.39 (95% CI 1.15 to 1.66) | 6 |