Samelson EJ et al. (2007) Vascular calcification in middle age and long-term risk of hip fracture: The Framingham study. J Bone Miner Res 22: 1449–1454

Population-based cohort studies have previously shown a correlation between bone loss and progression of aortic calcification, as well as an inverse relationship between bone mass and incidence of coronary heart disease, in postmenopausal women. Other studies have found a correlation between cardiovascular disease-associated mortality and low bone mineral density, increased bone loss and vertebral fracture.

This prospective study involving 2,499 (1,453 female and 1,046 male) cohort members of the Framingham Heart Study analyzed the effect of vascular calcification in middle age on participants' subsequent risk of hip fracture. The mean age of participants at the start of the study was 61 years and mean follow-up duration was 21 years, with follow-up consultations scheduled every 2 years. Multivariable statistical models were adjusted for age, BMI, coronary heart disease, diabetes, estrogen use (in women), smoking, systolic blood pressure and total cholesterol. One potential limitation of this study was the analysis of vascular calcification using plain radiographs rather than current technologies, such as CT.

Cumulative incidence of hip fracture did not differ between participants with the absence or presence of vascular calcification, nor did it increase with severity of aortic calcification. Increasing severity of aortic calcification was, however, highly associated with participant mortality. Samelson et al. concluded that the common radiographic finding of aortic calcification should not be used to identify individuals with an increased risk of hip fracture.