@article {7344, title = {Bone Mineral Density and Risk of Heart Failure in Older Adults: The Cardiovascular Health Study.}, journal = {J Am Heart Assoc}, volume = {6}, year = {2017}, month = {2017 Mar 13}, abstract = {

BACKGROUND: Despite increasing evidence of a common link between bone and heart health, the relationship between bone mineral density (BMD) and heart failure (HF) risk remains insufficiently studied.

METHODS AND RESULTS: We investigated whether BMD measured by dual-energy x-ray absorptiometry was associated with incident HF in an older cohort. Cox models were stratified by sex and interactions of BMD with race assessed. BMD was examined at the total hip and femoral neck separately, both continuously and by World Health Organization categories. Of 1250 participants, 442 (55\% women) developed HF during the median follow-up of 10.5~years. In both black and nonblack women, neither total hip nor femoral neck BMD was significantly associated with HF; there was no significant interaction by race. In black and nonblack men, total hip, but not femoral neck, BMD was significantly associated with HF, with evidence of an interaction by race. In nonblack men, lower total hip BMD was associated with higher HF risk (hazard ratio, 1.13 [95\% CI, 1.01-1.26] per 0.1~g/cm(2) decrement), whereas in black men, lower total hip BMD was associated with lower HF risk (hazard ratio, 0.74 [95\% CI, 0.59-0.94]). There were no black men with total hip osteoporosis. Among nonblack men, total hip osteoporosis was associated with higher HF risk (hazard ratio, 2.83 [95\% CI, 1.39-5.74]) compared with normal BMD.

CONCLUSIONS: Among older adults, lower total hip BMD was associated with higher HF risk in nonblack men but lower risk in black men, with no evidence of an association in women. Further research is needed to replicate these findings and to study potential underlying pathways.

}, issn = {2047-9980}, doi = {10.1161/JAHA.116.004344}, author = {Fohtung, Raymond B and Brown, David L and Koh, William J H and Bartz, Traci M and Carbone, Laura D and Civitelli, Roberto and Stein, Phyllis K and Chaves, Paulo H M and Kestenbaum, Bryan R and Kizer, Jorge R} } @article {9248, title = {Sex- and race-specific associations of bone mineral density with incident heart failure and its subtypes in older adults.}, journal = {J Am Geriatr Soc}, year = {2022}, month = {2022 Nov 05}, abstract = {

BACKGROUND: Previous studies have suggested an association between bone mineral density (BMD) and heart failure (HF) risk that may be race-dependent.

METHODS: We evaluated the relationship between BMD and incident HF in a cohort of older adults, the Health, Aging, and Body Composition (Health ABC) study (n~=~2835), and next performed a pooled analysis involving a second older cohort, the Cardiovascular Health Study (n~=~1268). Hip BMD was measured by dual-energy X-ray absorptiometry in both cohorts and spine BMD by computed tomography in a subset from Health ABC.

RESULTS: In Health ABC, lower BMD at the total hip was associated with higher incident HF in Black women after multivariable adjustment. Similar associations were found for BMD at the femoral neck and spine. In both cohorts, pooled analysis again revealed an association between lower total hip BMD and increased risk of HF in Black women (HR~=~1.41 per 0.1-g/cm decrement [95\% CI~=~1.23-1.62]), and showed the same to be true for White men (HR~=~1.12 [1.03-1.21]). There was a decreased risk of HF in Black men (HR 0.80 [0.70-0.91]), but no relationship in White women. The associations were numerically stronger with HFpEF for Black women and White men, and with HFrEF for Black men. Findings were similar for femoral neck BMD. Sensitivity analyses delaying HF follow-up by 2 years eliminated the association in Black men.

CONCLUSIONS: Lower BMD was associated with higher risk of HF and especially HFpEF in older Black women and White men, highlighting the need for additional investigation into underlying mechanisms.

}, issn = {1532-5415}, doi = {10.1111/jgs.18121}, author = {Gao, Hans and Patel, Sheena and Fohtung, Raymond B and Cawthon, Peggy M and Newman, Anne B and Cauley, Jane A and Carbone, Laura and Chaves, Paulo H M and Stein, Phyllis K and Civitelli, Roberto and Kizer, Jorge R} }