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The hidden link between heart health and bone strength
When we think about heart health, bones usually don’t come to mind.
But growing research shows a powerful connection: the same choices that protect your heart may also strengthen your bones — and vice versa.
Shared Risk Factors Across Systems
Osteoporosis and cardiovascular disease may seem like two completely different conditions, but they often share the same root causes. Poor diet, a lack of physical activity, smoking, and chronic inflammation can all increase your risk for both.
Research has shown that people with low bone mineral density are more likely to experience heart-related events. Likewise, signs of atherosclerosis —hardening and narrowing of the arteries — are more common in individuals with weaker bones.
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Lifestyle and Fracture Risk
One large U.S. study looked at how cardiovascular health scores — based on the American Heart Association’s Life’s Essential 8 — related to fracture risk. These eight key health factors include diet, physical activity, sleep, smoking, body weight, cholesterol, blood sugar and blood pressure.
The study found that people with better scores had a significantly lower risk of bone fractures. Compared to individuals with poor cardiovascular health, those with moderate scores had a 22% lower fracture risk, and those with high scores had a 34% lower risk.
This tells us that small steps you take to support your heart — like going for a daily walk or choosing whole foods over processed ones — can also help keep your bones strong.
How Inflammation and Hormones Affect Both Heart and Bone Health
Research has shown that heart disease and osteoporosis often develop together, and inflammation and hormones are two key reasons why.
Chronic inflammation, which plays a major role in heart disease, also contributes to bone loss. When inflammation levels are high, the body produces chemicals that can weaken bone and damage blood vessels at the same time. This means that the same internal stress that leads to clogged arteries can also make bones more fragile.
Hormonal changes, especially in women, add another layer of connection. Estrogen helps protect both the heart and the bones. After menopause, when estrogen levels drop, the risk for both heart disease and osteoporosis accelerates. That’s why, later in life, women often experience both conditions.
The overlap goes deeper. According to research, calcium deposits found in arteries and bone loss seen in osteoporosis may actually be driven by some of the same biological processes. In other words, the breakdown of bone and the buildup of plaque in blood vessels may be two sides of the same coin.
It all serves as a reminder that the body works as an interconnected system. Supporting hormone health and reducing inflammation through healthy habits (and hormone replacement therapy when appropriate) can go a long way in protecting both your heart and your bones.
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Statins and Bone Health
Statins are best known for lowering cholesterol, but they could offer benefits for bones too. Although confounding variables may be at play, several studies suggest that statins can stimulate the growth of bone-forming cells and reduce bone breakdown.
Statins appear to increase levels of a key protein that helps bones grow, while also lowering inflammation and possibly enhancing estrogen activity. These effects have been linked to improved bone mineral density and a reduced risk of fractures, especially in older adults and postmenopausal women.
Having said that, it is possible that these findings are associations rather than causations. People who take statins may be under more regular medical care, might be more attentive to their health in general, and might be more likely to pursue an active lifestyle. The jury is still out on how helpful statins are to bone health. But while more research is needed to fully understand the best use of statins for bone support, these findings suggest that statins certainly do not promote bone loss!
A Whole-Body Approach to Better Health
When it comes to protecting your health, there’s no need to compartmentalize. Your bones and your heart benefit from the same healthy habits:
- Eat a whole-food, anti-inflammatory diet, rich in fruits, vegetables, whole grains, and healthy fats.
- Get regular physical activity, including weight-bearing and resistance training, which supports both cardiovascular fitness and bone density.
- Don’t smoke, and take steps to manage blood pressure, blood sugar, and cholesterol.
- Talk to your doctor about your risk factors and whether bone density testing is right for you. By the way, this last piece of advice applies to everyone. Although less likely, men with risk factors can get osteopenia and osteoporosis too.
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By Dr. Elizabeth Klodas MD, FACC
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