Cardiovascular disease and osteoporosis: balancing risk management

Abstract

In this narrative review of the current literature, we examine the traditional risk factors and patient profiles leading to cardiovascular disease and osteoporosis. We discuss the interrelationships between risk factors and common pathophysiological mechanisms for cardiovascular disease and osteoporosis. We evaluate the increasing evidence that supports an association between these disabling conditions. We reveal that vascular health appears to have a strong effect on skeletal health, and vice versa. We highlight the importance of addressing the risk benefit of preventative interventions in both conditions. We discuss how both sexes are affected by these chronic conditions and the importance of considering the unique risk of the individual. We show that habitual physical activity is an effective primary and secondary preventative strategy for both cardiovascular disease and osteoporosis. We highlight how a holistic approach to the prevention and treatment of these chronic conditions is likely warranted.

Figure 1

Prevalence of traditional risk factors for cardiovascular disease in Canadian society according to gender. Note: High cholesterol was defined as a plasma cholesterol level above of 5.2 mmol ·L^-1; Diabetes was evaluated by self-report; Hypertension was defined as a blood pressure of ≥140/90 mmHg; Inactivity was defined as an usual daily leisure-time energy expenditure of <1.5 kcal ·kg^-1·day^-1; Smoking was defined as daily tobacco smoking; Obesity was defined as a body mass index of >27; Alcohol was defined as alcohol use in excess of 9 and 14 drinks per week for women and men, respectively. Source: Statistics Canada, National Population Health Survey, 1996/97 and the Heart and Stroke Foundation of Canada, The Changing Face of Heart Disease and Stroke in Canada 2000, October 1999 (Heart and Stroke Foundation of Canada 2000, Statistics Canada 1999b).

Figure 2

Life expectancy and health-adjusted life expectancy in representative nations. Abbreviations: LEX, Life Expectancy; HALE, Health-Adjusted Life Expectancy; JPN, Japan; SWI, Switzerland; AUS, Australia; SWE, Sweden; FRA, France; CAN, Canada; ITA, Italy; SPN, Spain; NOR, Norway; NZL, New Zealand; UK, United Kingdom; USA, United States of America; SL, Sierra Leone. The Health-Adjusted Life Expectancy (HALE) Takes into account the years of ill-health, weighted according to severity, and subtracted from the anticipated life expectancy to provide the equivalent years of healthy life. Source: World Health Organization, World Health Report 2001. (World Health Organization 2001).