Evidence map›Paper›PMID 30132027›Full record

ArticleOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2018

The associations of subclinical atherosclerotic cardiovascular disease with hip fracture risk and bone mineral density in elderly adults.

J I Barzilay, P Buzkova, J A Cauley, J A Robbins, H A Fink, K J Mukamal

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
2.0field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. The Analysis for Anemia Increasing Fracture Risk.Medical science monitor : international medical journal of experimental and clinical research · 2020
    Pooled it
  4. Article
  5. Association of healthy sleep pattern with the risk of falls and fractures among individuals with cardiovascular disease: a UK Biobank study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026
    Article
  6. Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Age-Related Factors Associated With The Risk of Hip Fracture.Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists · 2023
    Review
  14. Article
  15. The association between peripheral arterial disease and risk for hip fractures in elderly men is not explained by low hip bone mineral density. Results from the MrOS Sweden study.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2022
    Observational
  16. Article
  17. Article
  18. Article
  19. Observational
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 6 institutions in 1 country.

J I BarzilayKaiser Permanente of Georgia, Division of Endocrinology and the Division of Endocrinology, Emory University School of Medicine, 3650 Steve Reynolds Blvd, Duluth, GA, 30096, USA. joshua.barzilay@kp.org.ORCID http://orcid.org/0000-0001-7044-4166
P BuzkovaDepartment of Biostatistics, University of Washington, Seattle, WA, USA.
J A CauleyDepartment of Epidemiology, Graduate School, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
J A RobbinsDepartment of Medicine, University of California at Davis, Modesto, CA, USA.
H A FinkGeriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, MN, USA.
K J MukamalDepartment of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA.
Beth Israel Deaconess Medical Center · USGeriatric Research Education and Clinical Center · USKaiser Permanente · USUniversity of California, Davis · USUniversity of Pittsburgh · USUniversity of Washington · US

Funding

Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5M
CHS Events Follow-up StudyU01HL080295 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE M · 2005 to 2008
$4.6M
Role of EIIIA fibronectin in pulmonary fibrosisR01HL085083 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI WHITE, ERIC S · 2007 to 2011
$1.9M
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085081 · HC · JOHNS HOPKINS UNIVERSITY · PI FRIED, LINDA P · 1988 to 2000
–
CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84N01HC085082 · HC · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KULLER, LEWIS H · 1988 to 2000
–
CHS-Transition Phase -268055222-268055222N01HC055222 · HC · UNIVERSITY OF WASHINGTON · PI KRONMAL, RICHARD A · 2005 to 2006
–
CENTRAL BLOOD ANALYSIS LABORATORY FOR CHSN01HC085086 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1988 to 2000
–
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085083 · HC · UNIVERSITY OF CALIFORNIA DAVIS · PI ROBBINS, JOHN A · 1988 to 1999
–
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65 TO 84N01HC085079 · HC · UNIVERSITY OF WASHINGTON · 1988 to 2005
–
CORONARY HEART DISEASE &STROKE IN THE ELDERLYN01HC085080 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1988 to 2000
–
NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS This research was supported by contracts HHSN268201200036C, HHSN268200800007C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, and grant U01HL080295 from the National Heart, Lung, and Blood Institute (NHLBI), with additional contribution from the National Institute of Neurological Disorders and Stroke (NINDS). Additional support was provided by R01AG023629 from the National Institute on Aging (NIA). A full list of principal CHS investigators and institutions can be found at CHS-NHLBI.org. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The funding institution did not play a role in the creation of this publicationNHLBI NIH HHS U01 HL080295NIA NIH HHS R01 AG023629
6 · The paper itself

Abstract

In the absence of clinically recognized cardiovascular disease, increased carotid artery intimal medial thickness was associated with higher hip fracture risk in older adults, despite its association with higher bone mineral density (BMD). Low ankle brachial index and aortic wall thickness were not associated with fracture risk or BMD.

introductionClinically recognized cardiovascular disease (CVD) is associated with osteoporosis and hip fracture risk, but the relationship of subclinical atherosclerosis to bone health is not certain.

methodsWe followed 3385 participants from the Cardiovascular Health Study (mean age 74.7 ± 5.3 years) with a median time to fracture of 12.1 years who underwent baseline carotid artery and aortic wall ultrasound scanning and ankle brachial blood pressure index (ABI) determinations. A subset underwent bone mineral density (BMD) testing.

resultsThere were 494 hip fractures during follow-up. Among persons without clinical CVD, an average standard-deviation increase in a composite score of maximal common and internal carotid artery intimal medial thickness (cIMT) was associated with increased risk of hip fracture [(HR 1.18 [1.04, 1.35]), even though cIMT was positively associated with BMD. Neither aortic wall thickness nor ABI were associated with hip fracture risk or BMD. Among participants with clinical CVD, cIMT and aortic wall thickness, but not ABI, were associated with increased hip fracture risk.

conclusionSubclinical cIMT is associated with an increased risk of hip fractures despite being associated with increased BMD. This finding suggests that vascular health, even in its early stages, is linked to bone health, by pathways other than BMD.

Indexed as

Absorptiometry, PhotonAgedAged, 80 and overAtherosclerosisBone DensityCarotid Artery DiseasesFemaleFollow-Up StudiesHealth SurveysHip FracturesHumansMaleOsteoporotic FracturesRisk AssessmentUnited StatesBone mineral densityHip fractureRiskSubclinical atherosclerosis

Identifiers

PMID30132027
PMCPMC6487649
OpenAlexW2888489546

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.