Introduction: A relation between cardiovascular diseases and bone health is increasingly reported. However, the association between osteoporosis and incident heart failure (HF) has not been yet determined.
Objective: We aimed to summarize available evidence to evaluate whether osteoporosis was associated with an increased risk of incident HF.
Patients and methods: Major databases, including PubMed, Embase, the Cochrane library, Web of Science, and ClinicalTrials, were searched for cohort studies reporting the hazard ratio (HR) for incident HF in patients with osteoporosis. The pooled hazard ratios (HRs) and 95% CIs were estimated by using a random‑effects model. Heterogeneity was evaluated by the I2 statistics and the χ2 test.
Results: Three studies with a total of 70 697 patients were included, with the mean (SD) age of 62.9 (13.3) years. Osteoporosis was associated with an increased overall risk of incident HF (pooled HR, 1.17; 95% CI, 1.08-1.26; P <0.001; heterogeneity I2 = 13.28%, P = 0.32). The risk of incident HF was elevated in osteoporotic men (HR, 1.3; 95% CI, 1.05-1.62; P = 0.02; I2 = 71.57%, P = 0.03); however, no significant association was found for women (HR, 1.14; 95% CI, 0.94-1.37; P = 0.19; I2 = 64.66%, P = 0.06). The association between osteoporosis and incident HF risk was positive among individuals of Asian ethnicity (HR, 1.18; 95% CI, 1.06-1.3; P = 0.002; I2 = 52.61%, P = 0.15).
Conclusions: Osteoporosis was associated with a modest but significantly increased risk of incident HF. Considering the limited number and quality of available studies, future high‑quality data are required to further demonstrate the association between osteoporosis and incident HF.