Importance of bone densitometry in cardiovascular risk prediction

Overview

Cardiovascular diseases (CVD) are the most common causes of mortality and morbidity in Slovakia, and therefore early assessment of cardiovascular risk profile for asymptomatic subjects remains one of the major medical problems. Recently, in addition to assessing standard cardiovascular risk factors (CV), attention on to the evaluation of abdominal aortic calcifications is focused. Several studies have shown incidence of aortic calcification as an independent risk factor of developing CV mortality, including ischemic stroke. To quantify aortic calcifications several scoring systems have been developed and many authors have shown that high aortic calcification index positively correlates with CV risk, independently of the presence of classical CV risk factors. Increased interest in their evaluation was also enhanced by the broadening of methods used for identifying calcifications in vessels such as USG, X-ray and CT, but also the use of a bone densitometry (DXA), which became a widely available method. To detect aortic calcifications by DXA a lateral projection could be used, similarly to detection of asymptomatic vertebral fractures. An indisputable advantage of the method is the fact that many patients in the elderly are undergoing this exa­mination and generally they do not have assessed a CV risk profile. In addition, the relationship between osteoporosis, metabolic syndrome and cardiovascular morbidity has been revealed in recent years. Therefore, physicians managing osteoporosis could contribute to early detection of “asymptomatic” patients with increased CV risk and initiate preventive or therapeutic measures in subsequent collaboration with other specialists to reduce CV morbi­dity and mortality. In this review, we are describing possibilities to use DXA for assessment of aortic calcifications and its potential to prevent CVD among patients with osteoporosis.

Keywords:

cardiovascular risk – DXA