Bone mineral density and hip fracture analysis in patients with heart failure

Objective: Osteoporosis defined by low Bone Mineral Density (BMD), is a progressive disease affecting especially older adults. Hip fracture is the important result of osteoporosis. For the older adults, heart failure (HF) and osteoporosis are two common chronic conditions that are gaining importance for healthcare. The aim of this study is to evaluate bone mineral density and hip fractures in patients with heart failure Method: The study population consisted of 157 patients with heart failure and 155 control subjects without any cardiovascular disease and risk factors. All subjects underwent transthoracic echocardiography, biochemical analysis, and bone DEXA study. Osteoporotic fracture history and operation for fracture, list of current and prior use of medications were obtained from each center’s medical recordings. Results: Among the 157 patients, 45 (29%) had normal BMD, 14 (9%) had osteopenia, and 98 (62%) had osteoporosis. In 155 control subjects, 68 (44%) had normal BMD, 12 (8%) had osteopenia, and 75 (46%) had osteoporosis (P=0.019). Sixteen subjects (10.2%) in heart failure group and 6 subjects (3.9%) in controls had hip fracture (p=0.029). Level of 25-hydroxyvitamin D was significantly lower in heart failure than in controls (15.1±10.2 vs. 29.1±20.4 ng/ml; p<0.001).  Conclusions: Patients with heart failure have a lower bone mineral density, low vitamin D level and an increased rate of hip fractures. These findings can be explained by shared risk factors and pathogenetic mechanisms. Further prospective studies should be performed for evaluating the role of heart failure in osteoporotic hip fractures.