心血管疾病与骨质疏松.ppt

心血管疾病与骨质疏松症 广州市第一人民医院 刘丰 骨质疏松症的最大危害是骨折 高血压是骨折的危险因素 高血压与髋部骨折 心衰与髋部骨折 瑞典研究证明女性心衰病人髋部骨折的发生率增加2-3倍 加拿大研究证明心衰病人第一年髋部骨折的发生率比无心衰的其他心血管疾病组增加6倍 髋部骨折是心衰病人死亡的主要因素 心衰病人髋部骨折发病率显著提高 心血管疾病与髋部骨折-加拿大 Circulation. 2008;118:1946-1952 心血管疾病与髋部骨折 ?? Table 2 Odds ratios (OR) and 95% confidence intervals (CI) of hip fracture associated with previous diseases Crude Adjusted* Adjusted** OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI) Any cardiovascular disease 2.56 (2.17–3.01) 2.75 2.24–3.37 2.38 (1.92–2.94) Hypertension 2.94 (2.29–3.78) 3.72 2.74–5.05 2.76 (1.98–3.84) IHD 1.64 (1.29–2.09) 1.70 1.27–2.28 0.97 (0.70–1.35) Atherosclerosis 2.57 (1.60–4.13) 1.80 0.99–3.28 1.28 (0.67–2.45) Heart failure 2.64 (1.94–3.60) 2.51 1.68–3.74 1.82 (1.17–2.84) CVL 3.49 (2.60–4.69) 3.82 2.61–5.60 2.76 (1.85–4.13) CVD only 2.64 (2.16–3.23) 2.76 2.16–3.52 2.76 (2.16–3.52) CVD and any other disease 3.13 (2.42–4.04) 3.38 2.43–4.68 2.53 (1.29–4.96) IHD ischemic heart disease including heart infarction and angina pectoris CVL cerebrovascular lesion CVD cardiovascular disease *Adjusted for age (60, 60–64, 65–69, 70–74, 75–77, 78–81 year), BMI (20, 20–24.9, 25–29.9 and 30+ kg/m2 ), smoker (never, former and current), alcohol consumption (yes/no), physical activity (-1 and 2+ h/w), and use of HRT (yes/no). ** Including the covariates included above* and the following diseases as separate marker variables: malignancy, diabetes mellitus, psychiatric disorder, drug dependence, pneumonia, chronic obstructive lung disease, liver failure, and kidney failure. In