Hip fracture a significant concern in HF patients
MedWire News: Hip fracture is particularly common and a significant cause of mortality in heart failure (HF) patients, US researchers have found.
“The increasing survival rate for patients with HF places them at risk for other diseases of aging, including osteoporosis,” observe Laura Carbone (University of Tennessee Health Science Center, Memphis) and co-workers.
To investigate the impact of HF on hip fracture risk, the researchers followed-up 5613 participants of the Cardiovascular Health Study for an average of 11.5 years and compared the incidence of hip fracture in patients with and without HF.
The annual rate of hip fracture in participants with and without HF were 14.0 and 6.8 cases per 1000 person-years, the team reports in the European Heart Journal.
In initial analysis, HF was significantly associated with risk for hip fracture in men and women (hazard ratio [HR]=1.87 and 1.75, respectively). But the risks were attenuated (HR=1.59 and 1.41) and were no longer significant after adjusting for a raft of confounding factors including age, race, diabetes, smoking, and age at menopause.
In all, 57.5% of patients had died by the end of follow-up. Compared with participants with neither condition, men and women with hip fracture (HR=3.46 and 2.5, respectively) and HF (HR=3.22 and 3.69, respectively) had a significantly increased adjusted risk for mortality. The risk for mortality in patients with both conditions increased further to a HR of 5.85–6.15 in men and 4.38–6.80 depending on whether hip fracture preceded or followed HF.
Thus, after adjustment, men and women who experienced hip fracture after a diagnosis of HF were 1.91 and 1.84 times more likely to die than those with HF alone.
“Men and women with HF should be considered a high-risk population for hip fractures,” Carbone et al conclude. “However, the association between heart failure and hip fractures is at least partially explained by shared risk factors.”
Finding hip fracture a “substantial contributor to mortality in HF,” the team recommends that future research should investigate strategies to reduce osteoporosis and fracture risk in HF patients.
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By Lynda Williams