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Published on: May 31, 2016
Vascular calcification in middle age and long-term risk of hip fracture: the Framingham Study
Elizabeth J Samelson1, L Adrienne Cupples, Kerry E Broe
1Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts 02131, USA. samelson@hrca.harvard.edu
Insights
Vascular calcification in middle-aged adults does not increase long-term hip fracture risk. This study found no link between aortic calcification and subsequent hip fractures in men and women.
Area of Science:
- Gerontology
- Cardiovascular Health
- Bone Health
Background:
- Osteoporosis and atherosclerosis often coexist, suggesting shared underlying mechanisms.
- This research investigates the relationship between aortic calcification and hip fracture risk.
Purpose of the Study:
- To examine the association between the severity of aortic calcification in middle age and the subsequent risk of hip fracture.
- To determine if vascular calcification predicts hip fracture in a long-term population-based study.
Main Methods:
- The Framingham Study cohort, comprising 2499 participants (mean age 61), was analyzed.
- Abdominal aortic calcification severity was assessed using semiquantitative methods on baseline radiographs.
- Hip fractures were tracked over 35 years through active surveillance and medical record confirmation.
Main Results:
- No increased hazard ratio for hip fracture was observed across increasing categories of aortic calcification.
- Thirty-five-year cumulative hip fracture incidence was similar in individuals with and without aortic calcification.
- Aortic calcification was strongly associated with an increased risk of mortality in both women and men.
Conclusions:
- Vascular calcification in middle-aged adults does not appear to elevate long-term hip fracture risk.
- The findings suggest that aortic calcification is a marker for mortality risk rather than hip fracture risk.
Unlabelled:
Osteoporosis and atherosclerosis frequently occur in the same individuals and may share similar pathogenic mechanisms. This study examined the relation between severity of aortic calcification in middle-age years and subsequent risk of hip fracture in women and men in the population-based Framingham Study.
Introduction:
We assessed vascular calcification in women and men in middle age and risk of hip fracture at advanced age.
Materials And Methods:
Participants included 2499 Framingham cohort members (mean age, 61 yr; range, 47-80 yr). Semiquantitative methods were used to determine severity of abdominal aortic calcification on baseline radiographs. Information on potential confounding factors was obtained from study examinations conducted at, or before, baseline radiography. Hip fractures were ascertained by active surveillance and confirmed by medical records.
Results:
Thirty-five-year cumulative incidence of hip fracture was 16% in women and 5% in men with prevalent aortic calcification at baseline (score 1+) and 14% in women and 4% in men without aortic calcification (score 0). Hazard ratios (HRs) and 95% CIs for hip fracture did not increase from the lowest to the highest category of aortic calcification. HRs were 1.0, 1.2 (95% CI, 0.9-1.8), 1.2 (95% CI, 0.7-1.9), 1.1 (95% CI, 0.7-1.7), and 1.4 (95% CI, 0.8-2.3) in women (p for trend = 0.44) and 1.0, 1.8 (95% CI, 0.8-3.8), 1.8 (95% CI, 0.7-4.6), 1.5 (95% CI, 0.6-3.9), and 1.2 (95% CI, 0.2-5.7) in men (p for trend = 0.29) for aortic calcification scores 0 (reference), 1-4, 4-5, 6-10, and 11+, respectively. However, aortic calcification score was strongly associated with increased risk of death (p for trend < 0.0001 in women and men). HRs (95% CIs) for mortality from the lowest to highest aortic calcification score were 1.0, 1.6 (1.4-1.9), 1.7 (1.4-2.1), 1.8 (1.5-2.2), and 2.1 (1.7-2.6) for women, and for men were 1.0, 1.4 (1.1-1.6), 1.4 (1.2-1.8), 1.6 (1.3-2.0), and 1.9 (1.5-2.5).
Conclusions:
Vascular calcification in middle-aged adults does not increase long-term hip fracture risk.
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