Relationship Between Low Bone Mineral Density and Exercise-Induced Myocardial Ischemia

From, Aaron M.; Hyder, Joseph A.; Kearns, Ann E.; Bailey, Keru R.; Pellikka, Patricia A.
June 2007
Mayo Clinic Proceedings;Jun2007, Vol. 82 Issue 6, p679
Academic Journal
OBJECTIVE: To evaluate the relationship between bone mineral density (BMD) and ischemic heart disease and exercise capacity, as assessed by stress testing. PATIENTS AND METHODS: We retrospectively reviewed entries in the echocardiography database for 28,048 consecutive patients who underwent exercise echocardiography for standard clinical indications between August 1, 1998, and October 1, 2003, to determine which of these patients had also undergone dual-energy x-ray absorptiometry to measure femoral neck BMD before the procedure. Of the 1194 patients meeting both criteria, 28 were excluded because of missing data and 24 because they were tested with an exercise protocol other than the Bruce protocol, leaving 1142 patients to be included. RESULTS: Of the included study patients, 643 (56%) had a T score of -1.0 or less (mean age ± SD, 67±10 years; 87% women), and 499 (44%) had a T score greater than -1.0 (60±10 years; 90% women). For every 1-unit decrease in femoral neck T score, a 0.23 minute decrease in treadmill exercise duration was observed, once values had been adjusted for age and other patient characteristics (95% confidence interval [CI], 0.11–0.35; P<.001). Furthermore, for every 1-unit decrease in T score, there was a 22% increased risk of myocardial ischemia after adjustments (hazard ratio, 1.22; 95% CI, 1.06–1.41; P=.004). Overall, after adjustments, patients with a BMD of -1.0 or less who were referred for exercise echocardiography had a 43% greater risk of myocardial ischemia than did patients referred with normal BMD (hazard ratio, 1.43; 95% CI, 1.06–1.94; P=.02). CONCLUSIONS: Lower BMD is associated with myocardial ischemia and decreased exercise capacity during exercise echocardiography. Persons with low BMD who present with symptoms suggestive of cardiovascular disease are more likely to have myocardial ischemia than are those with normal BMD.


Related Articles

  • Unusual bone formation in the anterior rim of foramen magnum: cause, effect and treatment. Goel, Atul; Shah, Abhidha // European Spine Journal;Jun2010, Vol. 19, p162 

    A rare case of proatlas segmental abnormality resulting in a bony mass in the anterior rim of the foramen magnum is studied. Case report of a 19-year-old female showed a progressive weakness of all four limbs for about 3 years. When admitted she could not perform any useful activities by...

  • Coronary Heart Disease Risk and Bone Mineral Density Among U.S. Women and Men. Broussard, Danielle L.; Magnus, Jeanette H. // Journal of Women's Health (15409996);Apr2008, Vol. 17 Issue 3, p479 

    Aims: Low bone mineral density (BMD) has been shown to predict cardiovascular disease (CVD) and coronary heart disease (CHD) mortality in both women and men. The purpose of the current study was to determine whether a CHD risk assessment tool might be useful for identifying persons likely to...

  • LONG-TERM FOUR-YEAR EXERCISE HAS A POSITIVE EFFECT ON MENOPAUSAL RISK FACTORS: THE ERLANGEN FITNESS OSTEOPOROSIS PREVENTION STUDY. Kemmler, Wolfgang; Engelke, Klaus; Von Stengel, Simon; Weineck, Jürgen; Lauber, Dirk; Kalender, Willi A. // Journal of Strength & Conditioning Research (Allen Press Publish;Feb2007, Vol. 21 Issue 1, p232 

    The purpose of the study was to determine the effect of long-term exercise on coronary heart disease, osteoporotic risk factors, and physical fitness parameters in postmenopausal women. Forty early postmenopausal women (age 55. 1 ± 3. 3 years) with no medication or illness affecting bone...

  • Tissue viability by contrast echocardiography. Agati, Luciano; Funaro, Stefania; Madonna, Mariapina; Montano, Mariella; Berardi, Emanuela; Picardi, Maria Novella; Vizza, Carmine Dario; Labbadia, Alessandra; Francone, Marco; Carbone, Iacopo; Fedele, Francesco // European Journal of Echocardiography;Dec2006 Supplement 2, Vol. 7, pS22 

    Abstract: Residual tissue viability within the infarct area is one of the major determinants of regional functional recovery after acute myocardial infarction, playing also a protective role against LV remodelling. However, viability and functional recovery are not synonymous: functional...

  • Exercise echocardiography or exercise SPECT imaging? A meta-analysis of diagnostic test performance. Fleischmann, Kirsten E.; Hunink, Maria G.M.; Kuntz, Karen M.; Douglas, Pamela S.; Fleischmann, K E; Hunink, M G; Kuntz, K M; Douglas, P S // JAMA: Journal of the American Medical Association;9/9/98, Vol. 280 Issue 10, p913 

    Context: Cardiac imaging has advanced rapidly, providing clinicians with several choices for evaluating patients with suspected coronary artery disease, but few studies compare modalities directly.Objectives: To review the contemporary literature and to compare the...

  • Cola Intake May Decrease Bone Density in Women. Wagner, Elizabeth // Life Extension;Jan2007, Vol. 13 Issue 1, p16 

    The article reports on the findings of the study regarding the correlation between cola beverages and bone mineral density in the U.S. This study indicates that daily intake of cola reduces bone mineral density of the hip in older women. Specifically, the study found that drinking one daily...

  • Evaluation of Bone Mineral Density in Patients with Chronic Low Back Pain. Al-Saeed, Osama; Mohammed, Ahmed; Azizieh, Fawaz; Gupta, Renu // Asian Spine Journal;Jun2013, Vol. 7 Issue 2, p104 

    Study Design: This was designed as a retrospective study. Purpose: We investigated the relationship between bone mineral density (BMD) and chronic lower back pain (LBP). Overview of Literature: In spite of a large number of epidemiological surveys on the prevalence of LBP and BMD measurements...

  • INAA of Ca, Cl, K, Mg, Mn, Na, P, and Sr contents in the human cortical and trabecular bone. Zaichick, V. // Journal of Radioanalytical & Nuclear Chemistry;Sep2006, Vol. 269 Issue 3, p653 

    Concentration of Ca, Cl, K, Mg, Mn, Na, P, and Sr were determined by instrumental neutron activation analysis using short-lived radionuclides in intact cortical and trabecular bone of femoral neck and iliac crest of 81 relatively healthy 15-55 years old women ( n = 36) and men ( n = 45). In...

  • The blues break bones - study shows.  // Asian Pacific Post;12/6/2007, p19 

    The article reports on a U.S.-funded study which showed that women suffering from depression may be at risk of weakening of bones. The study found that the level of bone density loss attributed to depression was similar to other well known osteoporosis risk factors, such as smoking or doing...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics