The Link Between Osteoporosis and Cardiovascular Diseases: A Review of Shared Mechanisms, Risk Factors, and Therapeutic Approaches Publisher Pubmed



Mh Sharafi Mohammad HASAN ; A Nazari AFSHIN ; M Cheraghi MOSTAFA ; F Souri FARAZ ; M Bakhshesh MORTEZA
Source: Osteoporosis International Published:2025

Abstract

Background: Osteoporosis (OP) and cardiovascular diseases (CVDs) are prevalent age-related conditions that share common risk factors and underlying mechanisms, suggesting a bidirectional relationship. Methods: This review explores the intricate link between OP and CVD, focusing on shared pathways such as inflammation, oxidative stress, and the receptor activator of the nuclear factor-κB ligand-osteoprotegerin (OPG) system, which contribute to both bone loss and vascular calcification. Epidemiological studies reveal that low bone mineral density has been linked to an increased risk of cardiovascular mortality and morbidity, highlighting the interconnected nature of these conditions. Results: Key biological processes, including the osteogenic differentiation of vascular smooth muscle cells (VSMCs) and the role of bone-related proteins like osteopontin (OPN) and OPG, further underscore the overlap between bone metabolism and cardiovascular health. Common risk factors, such as aging, estrogen deficiency, vitamin D insufficiency, and lifestyle factors like smoking and physical inactivity, further link OP and CVD. Therapeutic interventions, including bisphosphonates, denosumab, and statins, have shown potential in addressing both conditions, suggesting that treatments targeting bone health may also benefit cardiovascular outcomes. However, the precise molecular mechanisms underlying these dual effects remain unclear, necessitating further research. Conclusion: This review synthesizes current knowledge on the shared pathophysiology, risk factors, and therapeutic approaches for OP and CVD, emphasizing the need for integrated management strategies. By understanding the interplay between bone and cardiovascular health, healthcare providers can develop more effective, holistic approaches to prevent and treat these interconnected conditions, ultimately improving patient outcomes. © 2025 Elsevier B.V., All rights reserved.