Patients who have been diagnosed with cardiovascular disease (CVD) are up to five times more likely to go on to develop hip fractures, a Swedish study has found.
Although CVD and osteoporosis are common among elderly patients, until now they have been regarded as independent age-related diseases.
The research team from Uppsala University in Sweden said that the latest findings, from a study involving twins, suggest that there may be a genetic link between the two diseases.
A total of 31,936 twins born between 1914 and 1944 were enrolled in the study. The participants were followed from the age of 50 for any signs of CVD or fracture. Overall, 19,186 patients were diagnosed with CVD during the study.
The researchers found that the rate of hip fractures was higher after a diagnosis of heart failure or stroke than after a diagnosis of peripheral atherosclerosis or ischaemic heart disease.
Patients who had been diagnosed with heart failure had a four-fold increased risk of hip fracture compared with patients who did not have CVD. Meanwhile patients who had suffered a stroke were five times as likely to have a hip fracture as patients without CVD.
Rates of hip fractures were higher in women than in men.
Lead researcher Dr Ulf Sennerby and colleagues said that pairs of identical twins were both likely to have an increased risk of hip fracture if one or other had suffered heart failure or a stroke.
This is an indication that genes predispose to the development of CVD and fractures, the researchers added.
'Most of the overall increased rate of hip fracture after heart failure appears to be explained by genes or by early environmental sharing,' they said.
The researchers concluded that doctors should be aware of the considerably increased rate of hip fracture, especially after a recent hospitalisation for CVD.
- JAMA 2009; 302: 1666-73