Researchers investigated a possible link between cardiovascular risk and fracture risk among postmenopausal women, a group already vulnerable to bone loss after falling estrogen levels. Using data from the Women’s Health Initiative, the study applied the American Heart Association’s PREVENT score, developed in 2024, to estimate each woman’s 10-year cardiovascular disease risk. More than 21,000 participants were classified as low, borderline, intermediate or high risk.
The analysis showed the strongest association with hip fractures. Women in the high cardiovascular risk group had a 93% higher risk of hip fracture compared with women in the low-risk group; those in the intermediate group had a 33% higher risk. The association was stronger for women younger than 65. For hip fractures the median time to fracture was about 15 years in the high-risk group versus nearly 20 years in the low-risk group.
Authors suggested multiple biological pathways that could link heart disease and bone loss, such as chronic inflammation, oxidative stress, altered calcium regulation, reduced blood flow to bone from atherosclerosis, and hormonal changes after menopause, especially declining estrogen. Lead author Rafeka Hossain of Tulane University noted surprise at the size of the hip fracture risk and said that many factors protecting the heart also protect bones. These include:
- regular physical activity
- a balanced diet rich in calcium and vitamin D
- not smoking and managing diabetes and high blood pressure
The PREVENT score might help identify patients for bone density screening or referral to a bone health specialist, but researchers caution that more work is needed before cardiovascular risk scores are added to standard fracture screening tools. Given the prevalence and economic burden of both conditions, reducing risk for both could improve the lives of older adults. "Taking care of your heart and bones should go hand in hand," Hossain said.
Difficult words
- cardiovascular — relating to the heart and blood vessels
- postmenopausal — after the end of menstrual periods
- atherosclerosis — hardening and narrowing of arteries
- oxidative stress — damage from unstable molecules in body
- prevalence — how common a disease or condition is
- bone density — amount of mineral in bones
- referral — sending a patient to another specialist
- estrogen — female sex hormone affecting bones
Tip: hover, focus or tap highlighted words in the article to see quick definitions while you read or listen.
Discussion questions
- How might using cardiovascular risk scores alongside current tools change screening and prevention for bone fractures in older women?
- Which of the lifestyle measures listed in the article do you think would be easiest for older adults to adopt, and why?
- What challenges could doctors face if they start using heart disease risk to decide who needs bone health care?
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