title: Risk of major osteoporotic fracture after cardiovascular disease: a population-based cohort study in Taiwan.
abstract: BACKGROUND
  We investigated the association between cardiovascular disease (CVD) and the risk of major osteoporotic fracture in Taiwan.
  
  
  METHODS
  Using the Taiwan National Health Insurance Database for the period 2000-2007, we classified 43 874 patients aged 50 years or older with newly diagnosed CVD (coronary artery disease, heart failure, cerebrovascular disease, or peripheral atherosclerosis) as the CVD group and 43 874 subjects without CVD (frequency-matched by sex, age, and date selected) as the non-CVD group. Incidence and hazard ratios (HRs) for major osteoporotic fracture of the spine, hip, humerus, and forearm/wrist were estimated for the period until the end of 2010.
  
  
  RESULTS
  After adjustment for confounders, the overall HRs for major osteoporotic fracture were 1.24 (95% CI = 1.13, 1.36) in men with CVD and 1.18 (95% CI = 1.11, 1.25) in women with CVD, as compared with the non-CVD group. As compared with the non-CVD group, the adjusted HR for major osteoporotic fracture was highest among subjects with cerebrovascular disease (HR 1.31; 95% CI 1.23, 1.39), followed by those with heart failure (HR 1.18; 95% CI 1.11, 1.27), peripheral atherosclerosis (HR 1.12; 95% CI 1.04, 1.20), and coronary artery disease (HR 1.07; 95% CI 1.01, 1.12).
  
  
  CONCLUSIONS
  CVD is associated with risk of major osteoporotic fracture in men and women in Taiwan.
authors.affiliation: School of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Lai
authors.forename: Kuan-Fu
authors.initials: KF
authors.lastname: Liao
authors.forename: Hsueh-Chou
authors.initials: HC
authors.lastname: Lai
authors.forename: Pang-Yao
authors.initials: PY
authors.lastname: Tsai
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Chen
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D058866:Osteoporotic Fractures / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology