Heart Failure Raises Risk of Fractures

(October 21, 2008) - Once a person is diagnosed with congestive heart failure (Read about "Congestive Heart Failure"), they also face other dangers such as bone fractures. (Read about "Bone Fractures") Heart failure patients are at higher risk for fractures, including debilitating hip fractures (Read about "The Hip"), than other heart patients and should be screened and treated for osteoporosis (Read about "Osteoporosis"), researchers reported in Circulation: Journal of the American Heart Association.

One year after an emergency room visit, 4.6 percent of heart failure patients experienced a fracture compared to only 1 percent of other heart patients. (Read about "Coronary Heart Disease") The one-year rate for hip fractures was 1.3 percent for heart failure patients compared to only 0.1 percent for other heart patients.

After researchers adjusted for other risk factors, heart failure patients had four times the risk of fracture and 6.3 times the risk of hip fracture as patients with heart attacks, chest pain or rhythm disturbances. (Read about "Heart Attack" "Angina" "Arrhythmia")

"This is the first study to link heart failure patients to a higher risk of fractures," said Justin A. Ezekowitz, M.D., senior author of the study.

The reasons for this remain unclear, Ezekowitz said. "It may be that heart failure patients aren't getting enough calcium or vitamin D." (Read about "Calcium" "Vitamins & Minerals") Furthermore they noted, parathyroid hormone, which handles calcium and magnesium affecting bone growth and rebuilding, may elevate as heart failure worsens. Two other possible reasons are dietary intake and less exercise.

"Most heart failure patients are placed on a strict diet, but some don't adhere to the diet or are less inclined to eat," Ezekowitz said. "Additionally, people with heart failure exercise less due to fatigue and a lower exercise tolerance. Lack of exercise can weaken the bones."