title: Bone Strength and Arterial Stiffness Impact on Cardiovascular Mortality in a General Population.
abstract: Osteoporosis and increased arterial stiffness independently have been found to be associated with higher cardiovascular events rates in the general population (GP). We examined 558 patients from GP by dual-energy X-ray absorptiometry (DXA) and pulse wave velocity (PWV) measurements at baseline, with 36-month follow-up period. DXA assessed bone mineral density of femoral neck (BMD FN) and lumbar spine (BMD LS). Carotid-femoral PWV was assessed by pulsed-Doppler. The aim of our study is to find correlation between bone strength and arterial stiffness and their impact on cardiovascular mortality in GP. The mean ± SD of BMD FN, BMD LS, and PWV was 0.852 ± 0.1432 g/cm(2), 0.934 ± 0.1546 g/cm(2), and 9.209 ± 1.9815 m/s. In multiple regression analysis we found BMD FN (βst = -6.0094, p < 0.0001), hypertension (βst = 1.7340, p < 0.0091), and diabetes (βst = 0.4595, p < 0.0046). With Cox-regression analysis, after 17 cardiovascular events, the significant covariates retained by the backward model were BMD FN (b = -2.4129, p = 0.015) and PWV (b = 0.2606, p = 0.0318). The cut-off values were PWV = 9.4 m/s, BMD FN = 0.783 g/cm(2), and BMD LS = 0.992 g/cm(2). The results for BMD FN and PWV hazard ratio risk were 1.116 and 1.297, respectively. BMD FN as a measure of bone strength and PWV as a measure of arterial stiffness are strong independent predictors of cardiovascular mortality in GP.
authors.affiliation: JZU Clinical Hospital "Dr. Trifun Panovski", Department of Internal Medicine, 7000 Bitola, Macedonia.
authors.forename: Petar
authors.identifier: 0000-0003-2816-3365
authors.initials: P
authors.lastname: Avramovski
authors.affiliation: University Clinic of Obstetrics and Gynecology, Medical Faculty, "Ss. Cyril and Methodius University" in Skopje, 1000 Skopje, Macedonia.
authors.forename: Maja
authors.initials: M
authors.lastname: Avramovska
authors.affiliation: University Clinic of Nephrology, Medical Faculty, "Ss. Cyril and Methodius University" in Skopje, 1000 Skopje, Macedonia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Sikole