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Review
. 2023 Jan-Dec:19:17455057231170059.
doi: 10.1177/17455057231170059.

Cardiovascular benefits and risks associated with calcium, vitamin D, and antiresorptive therapy in the management of skeletal fragility

Annop Kittithaworn  1 , David Toro-Tobon  1 , Jad G Sfeir  1   2
Affiliations
Review

Cardiovascular benefits and risks associated with calcium, vitamin D, and antiresorptive therapy in the management of skeletal fragility

Annop Kittithaworn et al. Womens Health (Lond). 2023 Jan-Dec.

Abstract

Osteoporosis affects one in every five women over the age of 50 worldwide. With a rapidly ageing population, the prevalence of fragility fractures, considered a largely preventable consequence of osteoporosis, is expected to increase. Age is also a major risk for cardiovascular disease and mortality, thus highlighting the importance of cardiovascular profiling of osteoporosis interventions. Although calcium and vitamin D are essential for a healthy bone metabolism, excessive supplementation may be associated with increased risk. Conversely, early pre-clinical data have suggested a possible cardiovascular benefit from bisphosphonate therapy. This review evaluates the evidence behind the cardiovascular benefits and risks that may be associated with osteoporosis therapy.

Keywords: Vitamin D; atrial fibrillation; bisphosphonates; calcium; cardiovascular risk; denosumab; osteoporosis.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Proposed mechanisms behind bisphosphonates cardiovascular benefits. This is hypothesized based on available preclinical and clinical data, some of which may have been limited to a single bisphosphonate agent. Furthermore, the data on the immunomodulatory effects of bisphosphonates are limited and its role in mediating any of the bisphosphonates’ effects is unclear.
See this image and copyright information in PMC

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