In heart failure patients with spinal fractures, osteoporosis is often untreated

By: Dr. Victor Marchione | Bone Health | Wednesday, October 19, 2016 - 12:00 PM

In heart failure patients with spinal fractures, osteoporosis is often untreatedIn heart failure patients with spinal fractures, osteoporosis is often untreated. Roughly one in 10 heart failure patients have compression fractures of the spine which could be detected by X-ray, but many of these patients don’t receive treatment in order to prevent these fractures.

In the study involving 623 heart failure patients, researchers found that 12 percent of the patients had moderate to severe vertebral compression fractures with 55 percent of them had multiple fractures. These types of fractures are indicative of osteoporosis. Only 15 percent of the patients with spinal fractures were being treated for osteoporosis.

Lead author of the study Kristin J. Lyons said, “Osteoporosis is an infrequently recognized and undertreated comorbidity of heart failure. Fortunately, the chest X-ray can be used as a case-finding tool to increase fracture identification.”

It’s important that doctors pay close attention to chest X-rays of their heart failure patients. Senior author Justin A. Ezekowitz added, “While reviewing chest X-rays to look at the heart and lungs, physicians also need to look carefully at the bones. If fractures are found, patients need to be treated with dietary modification, exercise and, if indicated, osteoporosis medications. Treatment can reduce future fractures by as much as 50 percent.”

“As the population ages, two of the most prevalent diseases are heart disease and osteoporosis. While hip fractures are the most devastating complication of osteoporosis, vertebral compression fractures are by far the most common. Unfortunately, 60 percent to 70 percent of spinal fractures are initially asymptomatic, escaping clinical detection yet placing the patients at higher risk for another vertebral facture and subsequent hip fractures,” Ezekowitz continued.

The researchers suggest that the link between heart failure and fractures may be explained by hyperaldosteronism (high levels of the hormone aldosterone). Aldosterone is produced by the adrenal gland to help regulate blood pressure and electrolytes, and balance fluids. Previous studies have linked high levels of this hormone with osteoporosis-related fractures. “Further study is needed, but it could be that treatment with an aldosterone antagonist like spironolactone could lower the incidence of fractures and atrial fibrillation in these patients,” Ezekowitz added.

Tips for living well with heart failure

First and foremost, if you are living with heart failure, it’s important that you follow the treatment plan prescribed by your doctor. This includes taking medications as directed, making the necessary lifestyle changes, incorporating activity into your life, not smoking if you are a smoker, and keeping up with your follow-up appointments.

Making appropriate lifestyle changes is not only helpful in living with heart failure but also in reducing the risk of a cardiovascular event like a heart attack. Healthy lifestyle involves eating a heart-healthy diet consisting of whole grains, fruits, and vegetables, reducing salt intake, and limiting your alcohol consumption and red meat.

It’s also important that you incorporate physical activity into your life for a heart stronger. Always speak to your doctor, though, for recommendations on the exercises that are safe for you to perform.

Lastly, you need to take care of your mind. It is easy to fall into a depression or other negative mental health state while living with heart failure. Reaching out to support groups is a way of combating anxiety and depression. It’s important to treat depression early on because it, too, can wreak havoc on your heart.

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