Elderly women with coronary artery disease (CAD) who were not receiving statin treatment were found to have lower femoral neck bone mineral density (BMD) compared with those who received statins. The relationship between statin use and improved BMD has been demonstrated in younger women, but this is the first time that it has been shown in older women — potentially translating to a reduction in the incidence of osteoporotic fractures in this high-risk population — according to research published in Women & Health.
Data were collected from 185 women aged ≥60 years at the time of their primary visit to an osteoporosis clinic for osteopenia, osteoporosis, or fragility fractures. Patients were categorized into 4 groups: history of CAD with statin use, history of CAD without statin use, no history of CAD with statin use, and no history of CAD with no statin use (control). Fourteen percent of the total had a history of CAD and 41% had a history of statin use. Of those taking statins, 46% were on simvastatin, 35% were on atorvastatin, 11% were on pravastatin, and 8% were on rosuvastatin.
The study revealed that elderly women with CAD but not taking a statin had 0.46 g/cm2 lower femoral neck BMD compared with patients without a history of CAD or statin use. In addition, the difference between BMD of the control group and BMD of patients taking statins — regardless of history of CAD — was insignificant. These findings indicate that statins may be effective in both the treatment of CAD and improvement of BMD in older patients.
“Our patient sample included patients greater than 79 years old in whom the risk of fractures is dramatically increased. This group of elderly women are excluded from ASCVD risk calculation for primary prevention of coronary death or nonfatal myocardial infarction, or fatal or nonfatal stroke with statins …” the investigators noted. “Our findings indicate that it may be beneficial to consider continuation of the use of statins, when indicated for CAD-related diagnoses in this population >79 years old potentially to increase BMD or to prevent bone loss and fragility fractures.”
Chiadika SM, Shobayo FO, Naqvi SH, Saraykar SS, Ambrose CG, Rianon NJ. Lower femoral neck bone mineral density (BMD) in elderly women not on statins [published online February 5, 2019]. Women Health. doi:10.1080/03630242.2019.1567646