Relation between postmenopausal osteoporosis and coronary and peripheral arterial disease

Abstract

Objectives: To study the relation between coronary artery disease (CAD) and peripheral arterial disease (PAD) with osteoporosis in postmenopausal women. Patients and methods: A 100 postmenopausal women were studied for evidence of osteoporosis by measurement of lumbar spine and femoral neck bone mineral density (BMD) and calculation of T score. From these cases; two groups were selected, group I included 30 cases with osteoporosis and group II included a matching 30 cases without osteoporosis or osteopenia as control group. Both groups were studied for prevalence of CAD using noninvasive tests including ECG, echocardiography and CT angiography, and prevalence of PAD using noninvasive tests including ankle brachial index (ABI) and color duplex study (CDS) of lower limb arteries. Results: Using CT angiogram, 17 cases (56.7%) had CAD in group I versus 6 cases (20%) in group II (p = 0.003). Prevalence of three vessel disease was significantly higher in group I than in group II (23.3% vs 3.3%, p = 0.022). In group I, there was a significant positive correlation between patients’ age with prevalence and severity of CAD in group I; and a significant negative correlation between T score with prevalence and severity of CAD. Presence of significant stenosis or occlusion in CDS of lower limb arteries was found in 6 cases (20%) in group I versus one case (3.3%) in group II (p = 0.044). Conclusion: Because of the increased prevalence of CAD and PAD in postmenopausal women with osteoporosis the severity of CAD and PAD in osteoporotic postmenopausal women is positively correlated to the severity of osteoporosis. Thus, in osteoporotic postmenopausal women, cardiovascular status evaluation should be done in order to identify candidate patients for preventive and therapeutic cardiovascular interventions.

Keywords

• Postmenopausal
• Osteoporosis
• Coronary artery disease
• Peripheral arterial disease