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Updated: Oct 3, 2026
Calcification of Vascular Smooth Muscle Cells and Imaging of Aortic Calcification and Inflammation
Published on: May 31, 2016
Bone loss and the progression of abdominal aortic calcification over a 25 year period: the Framingham Heart Study
D P Kiel1, L I Kauppila, L A Cupples
1Hebrew Rehabilitation Center for Aged Research and Training Institute and Harvard Medical School Division on Aging, Boston, MA, USA.
Insights
Bone loss is linked to worsening vascular calcification in older women. This study found that women with greater bone loss experienced more severe abdominal aortic calcification progression over 25 years.
Area of Science:
- Gerontology
- Cardiovascular Health
- Bone Metabolism
Background:
- Vascular calcification and osteoporosis are common age-related conditions.
- These conditions are often observed together on radiographs, with aortic calcification adjacent to osteopenic vertebrae.
Purpose of the Study:
- To test the hypothesis that abdominal aortic calcification progression is greatest in individuals with the most bone loss.
- To investigate the relationship between bone loss and vascular calcification in an aging population.
Main Methods:
- Utilized a population-based cohort from the Framingham Heart Study (364 women, 190 men).
- Radiographs of the lumbar spine and hand were taken between 1966-1970 and repeated 1992-1993.
- Aortic calcification was semiquantitatively assessed; bone loss was measured by relative cortical area (MCA) of the second metacarpal.
- Multivariate regression analyzed the 25-year progression of aortic calcification in relation to changes in MCA, adjusting for cardiovascular disease risk factors.
Main Results:
- Over 25 years, MCA decreased by 22.4% in women and 13.3% in men.
- Aortic calcification scores increased eightfold in women and sixfold in men.
- A significant association was found between bone loss (change in MCA) and abdominal aortic calcification progression in women (P=0.01), even after controlling for confounders.
- No significant association was observed in men.
Conclusions:
- This is the first longitudinal study to demonstrate a link between significant bone loss and severe abdominal aortic calcification progression in women.
- The findings suggest a potential relationship between the processes of osteoporosis and vascular calcification in aging women.
Abstract:
Vascular calcification and osteoporosis are common age-related processes that are prominently displayed on routine lateral lumbar spine radiographs as dense calcium mineral deposits of the aorta that lie adjacent to osteopenic vertebrae. Using a population-based cohort of older men and women, we tested the hypothesis that the progression of vascular calcification of the abdominal aorta should be greatest in those individuals with the greatest amount of bone loss. From the original population-based Framingham Heart Study cohort, 364 women and 190 men had lateral lumbar spine and hand radiographs performed between 1966 and 1970 and repeated between 1992 and 1993. The lateral lumbar films were read for the presence of aortic calcification using a semiquantitative method, and the hand films were read for second metacarpal relative cortical area (MCA). Using multivariate regression techniques, the 25-year progression of the abdominal aortic calcification index was examined in relation to the change in the MCA, while adjusting for recognized risk factors for atherosclerotic cardiovascular disease. During the 25 years of follow-up, the MCA decreased by 22.4% in women (from 79.6 +/- 7.8 (SD) to 61.8 +/- 10.3) and by 13.3% in men (from 80.6 +/- 6.9 to 69.9 +/- 8.3). The aortic calcification score increased over eightfold in women (from 1.2 +/- 2.7 (SD) to 9.9 +/- 6.7) and sixfold in men (from 1.6 +/- 2.8 to 9.6 +/- 6.3). There was a significant association between percent change in MCA and change in aortic calcification index (P = 0.01) in women after controlling for all potential confounders. No association was observed in men (P = 0.50), including the 50% of men with the greatest bone loss. This is the first longitudinal study to show that women with the greatest magnitude of bone loss also demonstrate the most severe progression of abdominal aortic calcification, suggesting that the two processes may be related.
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