Increased prevalence of peripheral arterial disease in osteoporotic postmenopausal women

• Published in: Journal of bone and mineral metabolism 2006-03, Vol.24 (2), p.125-131
• Main Authors: MANGIAFICO, Roberto Antonio, RUSSO, Enzo, RICCOBENE, Stefania, PENNISI, Pietra, MANGIAFICO, Marco, D'AMICO, Ferdinando, FIORE, Carmelo Erio
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Arteries - pathology; Biological and medical sciences; Blood and lymphatic vessels; Bone Density; Bones; Cardiology. Vascular system; Cardiovascular Diseases - pathology; Case-Control Studies; Confidence intervals; Disease; Diseases of the osteoarticular system; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Fractures, Bone; Humans; Logistic Models; Medical sciences; Middle Aged; Models, Statistical; Multivariate Analysis; Odds Ratio; Older people; Osteoporosis - diagnosis; Osteoporosis - pathology; Osteoporosis, Postmenopausal; Osteoporosis. Osteomalacia. Paget disease; Peripheral Vascular Diseases - complications; Peripheral Vascular Diseases - epidemiology; Postmenopause; Prevalence; Regression Analysis; Risk Factors
• ISSN: 0914-8779; 1435-5604
• DOI: 10.1007/s00774-005-0658-8

The aim of this study was to investigate the prevalence and correlates of peripheral arterial disease (PAD) in a population of osteoporotic postmenopausal women. The presence of PAD was assessed by ankle brachial index (ABI) in 345 ambulatory osteoporotic postmenopausal women, and in 360 community-based, age- and race-matched postmenopausal women with normal bone mineral density (BMD) (control group). PAD was detected in 63/345 (18.2%) osteoporotic women and in 14/360 (3.8%) control subjects (P < 0.0001). The mean ABI values were significantly lower in the osteoporosis group than in the control group (0.98 +/- 0.09 vs. 1.04 +/- 0.06, P < 0.0001). No difference in cardiovascular risk factors was observed between osteoporotic patients and controls, or between osteoporotic patients with and without PAD. Osteoporotic patients with PAD had lower femoral neck BMD T scores than those without PAD (-4.2 +/- 0.7 vs. -2.3 +/- 0.7, P < 0.0001). Only 4 PAD patients (5.1%) had intermittent claudication. In multivariate logistic regression analysis, factors independently associated with PAD within osteoporotic patients were lower femoral neck BMD T score (odds ratio (OR) = 0.20, 95% confidence interval (CI), 0.05-0.70, P = 0.01) and systolic blood pressure (OR = 1.02, 95% CI, 1.00-1.03, P = 0.01). This study shows for the first time an increased prevalence of PAD among osteoporotic postmenopausal women, with a lower femoral neck BMD T score being a significant independent predictor. The findings suggest that vascular status evaluation should be done in osteoporotic postmenopausal women in order to identify candidate patients for preventive and therapeutic cardiovascular interventions.