Low Bone Mineral Density, Coronary Heart Disease, and Stroke Mortality in Men and Women: The Third National Health and Nutrition Examination Survey

Purpose

The aim of this study is to determine the long-term association of bone mineral density and cardiovascular disease mortality.

Methods

The data used are from the Third National Health and Nutrition Examination Survey (NHANES III), a nationally representative sample of noninstitutionalized civilians. A cohort of white, black, and Mexican-American persons ages 50 years and older at baseline (1988–1994) was followed through 2000 for coronary heart disease (CHD; n = 4690) and stroke mortality (n = 5272) using the NHANES III Linked Mortality File.

Results

Death certificates were used to identify 369 CHD and 166 stroke deaths. Results were evaluated to determine the relative risk of CHD or stroke per one standard deviation lower bone mineral density after adjusting for multiple risk factors. In Cox proportional hazards models, risk of CHD death and risk of stroke death were not associated with low bone mineral density among men. For women, no significant associations were found for stroke (relative risk, 1.34; 95% confidence interval, 0.86–2.07, p = 0.20) or CHD (relative risk, 1.26; 95% confidence interval, 0.88, 1.80; p = 0.21).

Conclusions

Low bone mineral density was not associated with risk of cardiovascular disease in men. Among women with low bone mineral density, risk of CHD and stroke were elevated, but no significant associations were found.

Key Words: Bone Density, Coronary Disease, Cerebrovascular Accident, Follow-Up Studies, Longitudinal Studies, Proportional Hazards Models, Men, Women

Selected Abbreviations and Acronyms: CHD, coronary heart disease, BMD, bone mineral density, NHANES III, Third National Health and Nutrition Examination Survey, SD, standard deviation, RR, relative risk, CI, confidence interval