Abstract
Osteoporosis and cardiovascular disease are common conditions in older women, with a high prevalence and associated morbidity and mortality after the menopausal transition. Osteoporosis is more common in women than in men, occurring primarily after menopause when estrogen levels drop. Fractures are the most concerning complication of osteoporosis in women, with the hip, vertebrae, and forearm as the most common sites of fracture. Risk factors and non-pharmacologic prevention, diagnosis, and pharmacologic management are reviewed in this chapter. New attitudes toward the use of hormone replacement are also addressed.
Cardiovascular (CV) disease is the leading cause of death for women in the United States. Risk factors for cardiovascular disease are discussed in this chapter, specifically those unique to women such as polycystic ovarian syndrome, menopause, and certain complications of pregnancy.
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ACOG Osteoporosis Guidelines Issued. August 21, 2012 acog.org/About-ACOG/News-Releases/2012/Osteoporosis Guidelines-Issued last assessed Nov 13, 2016.
ACOG Practice Bulletin: clinical management guidelines for obstetrician-gynecologists. osteoporosis, Number 129, September 2012, reaffirmed 2014.
Acog.org/Resources%20And%20Publications/Practice%20Bulletins/Committee%20on%20oPractice%20Bulletins%20Gynecology/Osteoporosis.aspx last assessed November 12, 2016.
Anderson GL, Limacher M, Assaf AR, Bassford T, Beresford SA, Black H, et al. Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the women’s health Initiative randomized controlled trial. JAMA. 2004;291:1701–12.
Bellamy L, Casas JP, Hingorani AD, Williams D. Type2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373:1773–9.
Bouillon R, et al. Consensus development conference: prophylaxis and treatment of osteoporosis. Am J Med. 1991;90:107–10.
Cosman F, Lindsay R, LeBoff MS, Jan de Beur S, Tanner B, Dawson-Hughes B, Khosla S, Melton LJ, Tosteson ANA, Favus M, Baim S. Clinician’s guide to prevention and treatment of osteoporosis. Washington, DC: National Osteoporosis Foundation; 2013.
Downs JR, Clearfield M, Weis S, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998;279(20):1615–22.
Goff Jr DC, Lloyd-Jones DM, Bennett G, Coady S, D’Agostino Sr RB, Gibbons R, Greenland P, Lackland DT, Levy D, O’Donnell CJ, Robinson JG, Schwartz JS, Shero ST, Smith Jr SC, Sorlie P, Kessous R, Shoham-Vardi I, Pariente G, et al. An association between preterm delivery and long-term maternal cardiovascular morbidity. Am J Obstet Gynecol. 2013;209(4):368. e1–8.
Hodis HN, Mack WJ, Henderson VW, Shoupe D, et al. Vascular effects of early versus late postmenopausal treatment with estradiol. N Engl J Med. 2016;374:1221–31.
International Osteoporosis Foundation. Women over 50 will experience osteoporotic fractures, as wil men. Facts and statistics. Iofbonehealth.org/‘facts-statistics last asssessed November 13, 2016.
James PA, Oparil S, Carter BL, Cushman WC, Dennison-Himmelfarb C, Handler J, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8) [published erratum appears in JAMA 2014;311(17):1809]. JAMA. 2014;311(5):507–20.
Keaney JF, Solomon CG. Postmenopausal hormone therapy and atherosclerosis- time is of the essence. N Engl J Med. 2016;374:1279–80.
Kharazmi E, Dossus L, Rohrmann S, et al. Pregnancy loss and risk of cardiovascular disease: a prospective population-based cohort study (EPIC-Heidelberg). Heart. 2011;97(1):49.
Lyles KW, Colón-Emeric CS, Magaziner JS. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007;357:1799.
Manson JE, Allison MA, Rossouw JE, et al. Estrogen therapy and coronary-artery calcification. N Engl J Med. 2007;356:2591–602.
Mendelsohn ME, Karas RH. Molecular and cellular basis of cardiovascular gender differences. Science. 2005;308:1583–7.
Mosekilde L, Beck-Nielsen H, Sorensen OH, Nielsen SP, Charles P, Vestergaard P, et al. Hormonal replacement therapy reduces forearm fracture incidence in recent postmenopausal women – results of the Danish Osteoporosis Prevention Study. Maturitas. 2000;36:181–93.
Nakamura H, Arakawa K, Itakura H, et al. Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomized controlled trial. Lancet. 2006;368(9542):1155–63.
National Osteoporosis Foundation (NOF). 2015 [cited 18 April 2015]. Available from: www.nof.org.
NIH Consensus conference. Optimal calcium intake. NIH Consensus Development Panel on Optimal Calcium Intake. 1994 [cited 18 April 2015]; JAMA 272(24):1942.
Ray JG, Vermeulen MJ, Schull MJ, Redelmeier DA. Cardiovascular health after maternal placental – syndromes (CHAMPS): population-based retrospective cohort study. Lancet. 2005;366:1797–803.
Ridker PM, Danielson E, Fonseca FA, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008;359(21):2195–207.
Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, Jackson RD, Beresford SA, Howard BV, Johnson KC, Kotchen JM, Ockene J. Writing group for the women’s health initiative investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. JAMA. 2002;288:321–33.
Salley KE, Wickham EP, Cheang KI, et al. Glucose intolerance in polycystic ovary syndrome-a position statement of the Androgen Excess Society. J Clin Endocrinol Metab. 2007;92:4546.
Sampson HW. Alcohol and other factors affecting osteoporosis risk in women. NIH National Institute of Alcohol Abuse and Alcoholism [Internet]. 2003 [cited 18 April 2015]. Available from: http://pubs.niaaa.nih.gov/publications/arh26-4/292-298.htm.
Schierbeck LL, Rejnmark L, Tofteng CL L, et al. Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomized trial. BMJ. 2012;345:e6409.
Srivastava M, Deal C. Osteoporosis in elderly: prevention and treatment. Clin Geriatr Med. 2002;18:529–55.
Stone NJ, Robinson JG, Lichtenstein AH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association task force on practice guidelines. Circulation. 2014a;129(25 Suppl 2):S5.
Stone NJ, Wilson PW, American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014b;63(25 Pt B):2935–59.
WHO Technical Report Series. Prevention and management of osteoporosis. Geneva: World Health Organization; 2003.
Writing Group for the Women’s Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized controlled trial. Jama. 2002;288.3:321–33.
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Wade, K., Quaas, A.M. (2017). Management of Risks Factors for Older Women: Osteoporosis and Cardiovascular Disease. In: Shoupe, D. (eds) Handbook of Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-319-17798-4_47
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DOI: https://doi.org/10.1007/978-3-319-17798-4_47
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