Analysis of Bone Mineral Density and Hip Fracture in Geriatric Patients with Heart Failure

Objective: Osteoporosis, identified by low Bone Mineral Density (BMD), is a progressive disease affecting especially older adults. Hip fracture is the important result of osteoporosis. Heart failure and osteoporosis are two common chronic conditions that are critical in healthcare of older adults. This study is aimed at evaluating bone mineral density and hip fractures in geriatric aged patients with heart failure. Methods: We retrospectively analyzed 157 geriatric patients with heart failure and 155 geriatric control subjects without any cardiovascular disease and risk factors. The results of transthoracic echocardiography, biochemical analysis and bone mineral densitometry results (DEXA) were evaluated from patient file data. Medical records of clinics provided the osteoporotic fracture history and operation for fracture, list of current and prior use of medications. Results: Among the 157 patients, 45 (29%) had normal BMD, 14 (9%) had osteopenia, and 98 (62%) had osteoporosis. In 155 control subjects, 68 (44%) had normal BMD, 12 (8%) had osteopenia, and 75 (46%) had osteoporosis (P=0.019). Sixteen subjects (10.2%) in heart failure group and 6 subjects (3.9%) in controls had hip fracture (p=0.029). Level of 25-hydroxy vitamin D was significantly lower in heart failure than in controls (p<0.001). Conclusions: Patients with heart failure have a lower bone mineral density, low vitamin D level and an increased rate of hip fractures. These findings can be explained by shared risk factors and pathogenetic mechanisms. Further prospective studies should be performed for evaluating the role of heart failure in osteoporotic hip fractures.