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Heart failure and fracture risk: a meta-analysis

G Ge1,2, J Li1, Q Wang3

  • 1Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, 610041, China.

Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
|June 21, 2019
PubMed

Insights

Heart failure patients face a significantly higher risk of fractures, particularly hip and humerus fractures. This finding highlights the need for increased attention to bone health in individuals with heart failure.

Area of Science:

  • Cardiology
  • Orthopedics
  • Gerontology

Background:

  • Heart failure (HF) is a complex clinical syndrome with significant morbidity and mortality.
  • Growing evidence suggests a potential link between HF and an increased risk of fractures.
  • Understanding this association is crucial for comprehensive patient management and preventative strategies.

Purpose of the Study:

  • To systematically evaluate the existing scientific literature and quantify the association between heart failure and fracture risk.
  • To synthesize data from multiple cohort studies to provide a robust estimate of fracture risk in HF patients.
  • To identify specific fracture types most commonly associated with heart failure.

Main Methods:

  • A comprehensive meta-analysis of observational studies was performed.
  • Relevant databases including PubMed, EMBASE, and Cochrane Library were searched for studies published up to April 2018.
  • Seven high-quality cohort studies, assessed using the Newcastle-Ottawa Scale, were included, encompassing data from 53,038 HF patients and 126,727 controls.

Main Results:

  • Patients with heart failure exhibited a significantly higher risk of any fracture compared to controls (RR 1.66, 95% CI 1.14-2.43).
  • A markedly increased risk was observed for hip fractures (RR 3.45, 95% CI 1.86-6.40) and humerus fractures (RR 1.91, 95% CI 1.07-3.40).
  • No significant association was found for vertebral or forearm fractures.

Conclusions:

  • This meta-analysis confirms that heart failure is associated with an elevated risk of overall fractures.
  • The risk is particularly pronounced for hip and humerus fractures, underscoring a critical need for bone health monitoring in HF patients.
  • Clinicians should consider bone health assessment and preventative measures for patients diagnosed with heart failure.

Keywords:
FractureHeart failureHip fractureMeta-analysis

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