Low bone mineral density is an independent risk factor for stroke and death.
BACKGROUND
Recent studies suggest a relationship between atherosclerotic disease and osteoporosis. The aim of the study was to investigate whether bone mineral density (BMD) was prospectively related to stroke and death.


METHODS
BMD (g/cm(2)) was measured in 4,302 men and women (mean age 59 years, range 40-75) at baseline. The main outcome measures included validated strokes and death.


RESULTS
After a mean follow-up time of 5.6 years (range 0-15.8 years), 139 strokes were registered and 224 subjects had died. After adjustment for age, sex and body mass index, decreased femoral neck BMD and osteoporosis were found to be independent predictors of stroke (hazard ratio, HR, for each standard deviation decrease in BMD = 1.23, 95% CI = 1.01-1.49, and HR for osteoporosis = 1.92, 95% CI = 1.11-3.30). After adjustment for the same variables, the risk of death during follow-up was related to femoral neck BMD (HR = 1.41, 95% CI = 1.21-1.64) and osteoporosis at baseline (HR = 2.05, 95% CI = 1.28-3.29). Adjustment also for smoking, hypertension, hyperlipidemia and diabetes did not change any of these results.


CONCLUSIONS
We found that decreased BMD as well as osteoporosis of the femoral neck are independently associated with stroke and death. Given the impact of osteoporosis and stroke on morbidity and mortality, this relationship is of high interest for further studies.
Nordström
Anna
A
Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, Umeå, Sweden. anna.nordstrom @ idrott.umu.se
Eriksson
Marie
M
Stegmayr
Birgitta
B
Gustafson
Yngve
Y
Nordström
Peter
P
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000000981:diagnostic imaging / Q000209:etiology* / Q000401:mortality*; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors