Heart Failure as a Risk Factor for Osteoporosis and Fractures

Curr Osteoporos Rep. 2012 Dec;10(4):258-69. doi: 10.1007/s11914-012-0115-2.


Although heart failure (HF) and osteoporosis are common diseases, particularly in elderly populations, patients with HF have an increased risk for osteoporosis. The relationship of HF with osteoporosis is modified by gender and the severity of HF. In addition, shared risk factors, medication use, and common pathogenic mechanisms affect both HF and osteoporosis. Shared risk factors for these 2 conditions include advanced age, hypovitaminosis D, renal disease, and diabetes mellitus. Medications used to treat HF, including spironolactone, thiazide diuretics, nitric oxide donors, and aspirin, may protect against osteoporosis. In contrast, loop diuretics may make osteoporosis worse. HF and osteoporosis appear to share common pathogenic mechanisms, including activation of the renin-angiotensin-aldosterone system, increased parathyroid hormone levels, and/or oxidative/nitrosative stress. HF is a major risk factor for mortality following fractures. Thus, in HF patients, it is important to carefully assess osteoporosis and take measures to reduce the risk of osteoporotic fractures.

Publication types

  • Review

MeSH terms

  • Absorptiometry, Photon
  • Age Factors
  • Body Composition
  • Bone Density
  • Heart Failure / chemically induced
  • Heart Failure / complications*
  • Heart Failure / drug therapy
  • Heart Failure / mortality
  • Humans
  • Osteoporosis / chemically induced
  • Osteoporosis / etiology*
  • Osteoporosis / mortality
  • Osteoporosis / prevention & control
  • Osteoporotic Fractures / chemically induced
  • Osteoporotic Fractures / etiology*
  • Osteoporotic Fractures / mortality
  • Osteoporotic Fractures / prevention & control
  • Prevalence
  • Risk Factors