Abstract 17712: Association of Bone Mineral Density With Cardiac Valvular and Annular Calcification in Community-dwelling Older Adults - The Cardiovascular Health Study
Introduction: The process of cardiac calcification bears a resemblance to bone metabolism and its regulation. Experimental studies suggest that bone mineral density (BMD) and valvular calcification may be reciprocally related, but available epidemiologic data are sparse.
Methods: We tested the hypothesis that BMD of total hip and femoral neck measured by dual-energy X-ray absorptiometry (DXA) are inversely associated with prevalence of 3 echocardiographic (echo) measures of cardiac calcification (mitral annular [MAC], aortic annular [AAC] and aortic valve calcification [AVC]) in 1,497 older adults from the population-based Cardiovascular Health Study. Analyses were stratified by sex. Relative risk (RR) regression was used to evaluate the adjusted risks of MAC, AAC and AVC individually with continuous BMD. Dose-response associations were assessed for MAC and AVC. Fully adjusted models included age, race, BMI, SBP, hypertensive therapy, diabetes, smoking, alcohol, physical activity, estrogen therapy, LDL, HDL, eGFR, and CVD.
Results: Median age was 75 years; 58% were women. Prevalence of MAC, AAC and AVC was 41%, 46% and 64%, respectively. After limited and full adjustment for potential confounders, no statistically significant associations were detected between continuous BMD at either site and all three measures of calcification. In fully adjusted models, the RR’s for MAC per 0.1 g/cm2 decrement in total hip and femoral neck BMD in women were 1.01 (95% CI 0.92-1.11) and 1.05 (0.94-1.17), respectively; the adjusted risk estimates were similar in men. However, there were increased risks for moderate/severe MAC compared with no MAC that were significant for femoral neck BMD (RR 1.66 per 0.1 g/cm2 decrement [1.06-2.60], p=0.026) but not total hip BMD (RR 1.33 [0.93-1.91], p=0.121) in women. A similar association was not observed in men, or in relation to graded AVC in either sex.
Conclusions: In older adults, BMD at the total hip or femoral neck was not significantly associated with echo measures of prevalent valvular/annular calcification in either sex, although there was evidence of an inverse association with moderate/severe MAC in women. These findings suggest a sex-specific link between osteoporosis and MAC that will require further evaluation.
Author Disclosures: D. Massera: None. S. Xu: None. T.M. Bartz: None. A.E. Bortnick: None. J.H. Ix: None. M. Chonchol: None. D.S. Owens: None. E. Barasch: None. J.M. Gardin: None. J.S. Gottdiener: None. J.A. Robbins: None. D.S. Siscovick: None. J.R. Kizer: Ownership Interest; Significant; Gilead Sciences, Inc; Pfizer, Inc.
- © 2016 by American Heart Association, Inc.