Heart Disease and Osteoporosis

Last year a study published in the journal Circulation suggests that up to 12% of people with heart failure may have osteoporosis as well as spine compression fractures that often are characteristic of the bone disease.  The researchers studied 623 heart failure patients and found that 12% had moderate to severe vertebral compression fractures; 55% of those people had multiple fractures. Fractures such as these can be a sign of osteoporosis, a disease in which the bones become less dense and more fragile.

The link between heart disease and osteoporosis is well established. This is why it is important to order heart related lab tests for patients with osteoporosis. Just looking at a standard lipid (cholesterol) panel is a thing of the past. More important is the particle size of the lipoproteins. Advanced testing of the High Density Lipoprotein HDL and Low Density Lipoprotein (LDL) is available. For instance, the HDL (good cholesterol) and the LDL (unfavorable cholesterol) can have large or small particle size. Small particle size of either increases the risk of heart disease. A specific small particle lipoprotein Lp(a) is especially problematic. High Lp(a) predicts risk of early atherosclerosis independently of other cardiac risk factors, including LDL. Inflammation markers are also important to assess such as CRP-hs and homocysteine. There are additional tests including vitamin D that should be included in the evaluation of potential developing heart disease.

Who should consider advanced heart disease testing? People who have:

• Who have a diagnosis of heart disease
• Family history of heart disease, especially those who have a family member who had an early heart attack.
• Diabetes
• Abnormal blood work such as a low HDL (higher is better, over 60) or an elevated LDL
• History or present use of tobacco or excessive alcohol
• A diet high in inflammatory foods including caffeine, processed carbohydrates (SUGAR) and meat.

What can be done about abnormal blood tests?

As it turns out, a lot can be done about abnormal blood work. Dietary changes and exercise are among the most important areas to assess, especially for those who consume a diet high in inflammatory foods mentioned above. This is where nutrition and supplementation become medicine. For some people high doses of fish oil is very effective and for a select few, low dose aspirin is a reasonable consideration. Only a small subset of those who carry the Lp(a) will benefit from aspirin therapy. For those who have elevated Lp(a) there is even a test to determine if the Lp(a) is sensitive and responsive to aspirin. The vast majority of people will not benefit from aspirin and in fact, are increasing their risk factors for bleeding conditions.

Head off heart disease with a healthy diet that includes plenty of fresh vegetables and fruit. Decrease or eliminate processed carbohydrates. Exercise daily and get your heart pumping for at least 45 minutes 3 times a week. Keep in mind that any and all exercise is good, even that 10 minute walk to the car is beneficial or taking the stairs instead of the escalator (up not down). If you have physical limitations find a way to exercise and move your body. You may need the help of a health care provider who specializes in exercise. Being conscious of your dietary choices and your exercise routing will go a long way to enhancing your overall health adding quality years to your life.