title: Bone Mineral Density and Risk of Heart Failure in Older Adults: The Cardiovascular Health Study.
abstract: BACKGROUND
  Despite increasing evidence of a common link between bone and heart health, the relationship between bone mineral density (BMD) and heart failure (HF) risk remains insufficiently studied.
  
  
  RESULTS
  We investigated whether BMD measured by dual-energy x-ray absorptiometry was associated with incident HF in an older cohort. Cox models were stratified by sex and interactions of BMD with race assessed. BMD was examined at the total hip and femoral neck separately, both continuously and by World Health Organization categories. Of 1250 participants, 442 (55% women) developed HF during the median follow-up of 10.5 years. In both black and nonblack women, neither total hip nor femoral neck BMD was significantly associated with HF; there was no significant interaction by race. In black and nonblack men, total hip, but not femoral neck, BMD was significantly associated with HF, with evidence of an interaction by race. In nonblack men, lower total hip BMD was associated with higher HF risk (hazard ratio, 1.13 [95% CI, 1.01-1.26] per 0.1 g/cm2decrement), whereas in black men, lower total hip BMD was associated with lower HF risk (hazard ratio, 0.74 [95% CI, 0.59-0.94]). There were no black men with total hip osteoporosis. Among nonblack men, total hip osteoporosis was associated with higher HF risk (hazard ratio, 2.83 [95% CI, 1.39-5.74]) compared with normal BMD.
  
  
  CONCLUSIONS
  Among older adults, lower total hip BMD was associated with higher HF risk in nonblack men but lower risk in black men, with no evidence of an association in women. Further research is needed to replicate these findings and to study potential underlying pathways.
authors.affiliation: Department of Medicine, Washington University School of Medicine, Saint Louis, MO.
authors.forename: Raymond B
authors.initials: RB
authors.lastname: Fohtung
authors.affiliation: Department of Medicine, Washington University School of Medicine, Saint Louis, MO.
authors.forename: David L
authors.initials: DL
authors.lastname: Brown
authors.affiliation: Department of Biostatistics, University of Washington School of Public Health, Seattle, WA.
authors.forename: William J H
authors.initials: WJ
authors.lastname: Koh
authors.affiliation: Department of Biostatistics, University of Washington School of Public Health, Seattle, WA.
authors.forename: Traci M
authors.initials: TM
authors.lastname: Bartz
authors.affiliation: Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA.|Charlie Norwood Veterans Affairs, Augusta, GA.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Carbone
authors.affiliation: Department of Medicine, Washington University School of Medicine, Saint Louis, MO.
authors.forename: Roberto
authors.initials: R
authors.lastname: Civitelli
authors.affiliation: Department of Medicine, Washington University School of Medicine, Saint Louis, MO.
authors.forename: Phyllis K
authors.initials: PK
authors.lastname: Stein
authors.affiliation: Benjamin Leon Center for Geriatric Research and Education, Department of Medicine, Family Medicine, and Community Health, Herbert Wertheim College of Medicine, Florida International University, Miami, FL.
authors.forename: Paulo H M
authors.initials: PH
authors.lastname: Chaves
authors.affiliation: Department of Medicine, University of Washington School of Medicine, Seattle, WA.
authors.forename: Bryan R
authors.initials: BR
authors.lastname: Kestenbaum
authors.affiliation: Departments of Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY jorge.kizer@einstein.yu.edu.
authors.forename: Jorge R
authors.initials: JR
authors.lastname: Kizer
mesh_terms: D015502:Absorptiometry, Photon; D001741:Black or African American; D000368:Aged; D015519:Bone Density; D018450:Disease Progression; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D006304:Health Status; D006333:Heart Failure / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010024:Osteoporosis / Q000150:complications* / Q000175:diagnosis / Q000208:ethnology; D010384:Pelvic Bones / Q000000981:diagnostic imaging; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D044465:White People
keywords: bone mineral density; heart failure; osteoporosis; race