Cardiovascular benefits and risks associated with calcium, vitamin D, and antiresorptive therapy in the management of skeletal fragility

Abstract

Osteoporosis affects one in every five women over the age of 50 worldwide. With a rapidly ageing population, the prevalence of fragility fractures, considered a largely preventable consequence of osteoporosis, is expected to increase. Age is also a major risk for cardiovascular disease and mortality, thus highlighting the importance of cardiovascular profiling of osteoporosis interventions. Although calcium and vitamin D are essential for a healthy bone metabolism, excessive supplementation may be associated with increased risk. Conversely, early pre-clinical data have suggested a possible cardiovascular benefit from bisphosphonate therapy. This review evaluates the evidence behind the cardiovascular benefits and risks that may be associated with osteoporosis therapy.

Osteoporosis and coronary heart disease: a bi-directional Mendelian randomization study

“…Furthermore, observations of patients' drug use and diet have reinforced the link between the two conditions. For instance, anticoagulants like warfarin and unfractionated heparin, commonly used in stroke and myocardial infarction patients, may increase the risk of OP (52) preventing and treating skeletal diseases with them. As highlighted earlier, the advantages of bone ultrasound render it a preferred choice.…”

“…For instance, anticoagulants like warfarin and unfractionated heparin, commonly used in stroke and myocardial infarction patients, may increase the risk of OP ( 52 ). Conversely, excessive calcium supplements, particularly in a calcium-sufficient diet, have been associated with elevated cardiovascular risk, especially myocardial infarction risk ( 53 ). Statins, commonly used lipid-lowering drugs in CVD treatment, have been linked to bone changes ( 54 ).…”