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Stroke, Vol 24, 940-946, Copyright © 1993 by American Heart Association
WS Browner, AR Pressman, MC Nevitt, JA Cauley and SR Cummings
BACKGROUND AND PURPOSE: To determine whether women with low bone mineral
density are at increased risk of stroke, the present study was conducted.
METHODS: We studied 4024 ambulatory women aged 65 years or older
participating in the prospective Study of Osteoporotic Fractures. Bone
mineral density was measured at baseline using single photon
absorptiometry; strokes were ascertained using a computerized Medicare data
base and death certificates. RESULTS: During a mean of 1.98 years of
follow-up, 83 women suffered first strokes (five fatal). Osteopenia was
associated with an increased stroke risk: Each SD decrease in bone mineral
density at the calcaneus (0.09 g/cm2) was associated with a 1.31-fold
increase in stroke (95% confidence interval, 1.03-1.65), adjusted for age,
follow-up time, and several potential confounders, including diabetes,
systolic blood pressure, use of alcohol, cigarettes or postmenopausal
estrogens, cognitive ability, grip strength, and functional ability. The
observed relation between bone density and stroke was strongest for
intracerebral hemorrhages and occlusions. CONCLUSIONS: Most likely, low
bone density does not cause stroke; some other process probably results in
both osteopenia and cerebrovascular disease.
ARTICLES
Association between low bone density and stroke in elderly women. The study of osteoporotic fractures
Department of Epidemiology and Biostatistics, University of California, San Francisco.
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