Illustration showing link between osteoarthritis and heart health
Credit: Tatiana Ayazo

Heart disease is a serious global health issue — about 523 million people worldwide are living with some form of cardiovascular disease. Meanwhile osteoporosis, a condition that causes bones to become weak, brittle, and break more easily, also poses a global health threat. The bone condition is thought to affect more than 200 million people across the world 

While osteoporosis may not be top of mind for those who are concerned about their heart, the bone condition has been linked to cardiovascular disease.

Here’s what to know to protect your health.  

The Link Between Osteoporosis and Your Heart 

Heart health and osteoporosis are thought to have a two-way relationship. “There’s an association between bone density and cardiovascular disease, meaning the lower your bone density, the higher your risk is of having cardiovascular disease,” says Scott Hummel, MD, Chair-Elect of the American College of Cardiology Geriatric Cardiology Leadership Council. “And then over time, people who have low bone density are more likely to develop cardiovascular disease.” 

While the exact relationship isn’t entire clear, notes Dr. Hummel, a few factors may come into play. 

Inflammation 

“Many forms of heart disease are inflammatory, and there’s thought to be a relationship between chronic inflammation and osteoporosis,” says Hummel. 

Studies have found that low-grade inflammation in the body is associated with both heart disease and osteoporosis. What’s more, chronic inflammatory conditions like rheumatoid arthritis and lupus accelerate these risks to bone and heart health.  

Shared Risk Factors 

Research shows that certain risk factors may increase your risk of both heart disease and osteoporosis, including: 

  • Aging 
  • Smoking 
  • Being inactive 
  • Being overweight 

Low vitamin D levels have also been associated with an increased risk of both osteoporosis and cardiovascular disease. In addition, both osteoporosis and heart disease are linked to a drop in estrogen in menopausal women.  

Osteoporosis Risk Factors 

While heart disease and osteoporosis share some risk factors, other factors also play a role in the development of this bone condition. These can be broken into two groups: uncontrollable and controllable risk factors. 

Uncontrollable risk factors for osteoporosis include:   

  • Gender: Osteoporosis is more common in women, especially in perimenopausal women.  
  • Ethnicity: Osteoporosis is more common in Caucasian and Asian women.  
  • Age: The older you get, the higher your risk of developing osteoporosis.  
  • Family history: If an immediate family member, like a parent, has osteoporosis, your risk of developing it increases.  

Controllable risk factors, or those you can modify, include:  

  • Medications: Aside from steroids, other medications like anticonvulsants may also contribute to osteoporosis.  
  • Diet: Low calcium and vitamin D intake may contribute to osteoporosis risk.  
  • Inactivity: Not exercising regularly or being inactive can weaken your bones whether you have asthma or not.  
  • Weight: Being underweight (or having a small body frame) can impact bone health.  
  • Smoking: Smoking cigarettes makes you more prone to osteoporosis and bone fractures.  
  • Alcohol: Excessive alcohol consumption impacts how the body absorbs calcium and vitamin D, both of which are critical for healthy bone development.  

By familiarizing yourself with the many risk factors tied to osteoporosis, you can have an informed conversation with your health care provider about your personal risk and what you can do to protect your bones. 

Osteoporosis Symptoms  

Osteoporosis is sometimes referred to as a “silent” condition. That’s because it often has no symptoms.   

As it progresses, it can lead to symptoms like   

  • Back pain  
  • Sudden back pain  
  • Joint pain  
  • Changes in posture  
  • Stooping or loss of height  

But most people aren’t aware they have osteoporosis until they fracture or break a bone. That’s why it’s so important to be aware of osteoporosis and take steps to protect your bone health.  

How to Manage Heart Health and Protect Your Bones 

These strategies can help you manage your heart health and keep bones healthy. 

Eat a Healthy, Nutritious Diet 

Evidence shows a heart-healthy diet plays an important role in preventing both primary and secondary cardiovascular events. Research also shows that poor dietary habits can contribute to the progression of osteoporosis — but following healthier eating habits may help decrease disease progression. 

Do your best to eat a well-balanced diet full of fruits, vegetables, fish, whole grains, and legumes. Aim to also get plenty of calcium and vitamin D — which can be found in dairy products like milk, cheese, and yogurt — to help preserve bone strength. 

Women ages 50 and under and men ages 70 and under should aim to get 1,000 mg of calcium each day and increase intake to 1,200 mg each day once women reach age 51 and men reach age 71. The recommended vitamin D intake is 400-800 IU a day for most adults under age 50, and 800-1,000 IU a day for those 50 and up. Talk to your doctor before taking changing your diet or taking supplements. 

Stay Active 

Research shows that exercising regularly can help reduce high blood pressure, improve cholesterol numbers, and lower the risk of developing heart disease. It can even reduce the risk of cardiovascular-related deaths. What’s more, exercise is also a key strategy for improving bone health and preventing osteoporosis. 

To promote cardiovascular health, plan to incorporate a mix of activities into your workout plan. When it comes to bone health, weight-bearing activities are especially important. Research has found that resistance exercises in particular can help preserve both bone and muscle mass.   

“Weight-bearing exercise is great for osteoporosis as long as you’re taking into account your risk of falling and taking appropriate precautions,” adds Dr. Hummel. Ask your doctor for guidance. 

Maintain a Healthy Weight 

While being underweight can increase your risk of osteoporosis, obesity can directly impact your heart health.  

Eating a healthy diet without overly restricting your caloric intake and staying active — particularly with strength-training exercises — may help you reach and maintain a healthy weight for your heart in a way that can also help protect your bones. Work with your health care provider to find the ideal weight for you and your overall health.   

Quit Smoking 

Smoking is bad for everyone — but it’s especially dangerous for people with heart disease. Research shows that smoking as well as exposure to secondhand smoke can increase your risk of heart disease-related mortality.  

Meanwhile, smoking can contribute to weakened bones and increase fracture risk. And many people who smoke also partake in other unhealthy lifestyle habits that affect both heart and bone health, like decreased activity levels and poor diet. 

The good news: It’s never too late to quit. Quitting smoking can help lower your risk of heart attack and reduce your risk of dying from heart disease. Findings from one study also show that quitting may help increase bone mass previously lost due to smoking.  

Ask your doctor if you need help with quitting. You may benefit from the use of a smoking cessation aid.   

Moderate Alcohol Use 

Research shows that drinking red wine in moderation can have protective heart benefits in comparison to other types of alcohol. However, excessive alcohol consumption — regardless of your drink of choice — can increase your risk of cardiac-related death.  

Chronic, excessive alcohol consumption has also been found to increase osteoporosis risk. What’s more, heavy drinking has been linked with a decrease in bone density and weakened bones.  

Additionally, those who drink alcohol excessively are also more likely to partake in other unhealthy lifestyle habits that affect bone health, including smoking and poor eating habits. 

Talk to your doctor about your drinking habits and whether you should cut back for your health.   

When to Talk to Your Doctor About Bone Health

Because there are often no symptoms of osteoporosis until a bone breaks, routine screening can help prevent osteoporosis. Screening is easy and only takes five to 10 minutes. Early detection can help you take proper steps to prevent fractures and promote bone health.   

Routine screening for osteoporosis should be done:    

  • After age 65 for women, 70 for men, or sooner depending on your personal risk factors  
  • Every one or two years, or more often depending on your health   
  • After a bone fracture in those over the age 50  
  • When taking new medication associated with low bone mass or bone loss  

Talk to your doctor at your next health exam about getting screened for osteoporosis.

This article was made possible with support from Amgen. 

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