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

Womens Health (Lond). 2023 Jan-Dec:19:17455057231170059. doi: 10.1177/17455057231170059.

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.

Publication types

  • Review

MeSH terms

  • Bone Density Conservation Agents* / adverse effects
  • Calcium / therapeutic use
  • Diphosphonates / therapeutic use
  • Female
  • Humans
  • Osteoporosis* / complications
  • Osteoporosis* / drug therapy
  • Risk Assessment
  • Vitamin D / therapeutic use

Substances

  • Vitamin D
  • Calcium
  • Bone Density Conservation Agents
  • Diphosphonates