Coronary heart disease risk and bone mineral density among US women and men

Aims: Low bone mineral density (BMD) has been shown to predict cardiovascular disease (CVD) and coronary heart disease (CHD) mortality in both women and men. The purpose of the current study was to determine whether a CHD risk assessment tool might be useful for identifying persons likely to have low BMD in a multiethnic population of women and men. Methods: Cross-sectional data for 3881 women and men aged 50-74 years without overt CHD or stroke from the Third National Health and Nutrition Examination Survey (NHANES III) were used to explore the relationship between BMD and 10-year CHD risk, as estimated using the Framingham CHD risk prediction algorithm, in gender-stratified multiple logistic regression models. Results: When compared with women who had a < 10% CHD risk, women with a 10%-19% CHD risk were 45% more likely and those with a >= 20% CHD risk were 73% more likely to have low BMD. Similar increases in low BMD risk were not detected in men. Conclusions: In the United States, 10-year Framingham CHD risk assessment may be useful for identifying older women who should be evaluated for osteoporosis and referred for BMD measurement. The impact of such a screening strategy on fracture prevention needs further elucidation.