Bone loss and the progression of abdominal aortic calcification over a 25 year period: The Framingham Heart Study

Vascular calcification and osteoporosis are common age-related processes th at are prominently displayed on routine lateral lumbar spine radiographs as dense calcium mineral deposits of the aorta that lie adjacent to osteopeni c vertebrae. Using a population-based cohort of older men and women, we tes ted the hypothesis that the progression of vascular calcification of the ab dominal aorta should be greatest in those individuals with the greatest amo unt of bone loss. From the original population-based Framingham Heart Study cohort, 364 women and 190 men had lateral lumbar spine and hand radiograph s performed between 1966 and 1970 and repeated between 1992 and 1993. The l ateral lumbar films were read for the presence of aortic calcification usin g a semiquantitative method, and the hand films were read for second metaca rpal relative cortical area (MCA). Using multivariate regression techniques , the 25-year progression of the abdominal aortic calcification index was e xamined in relation to the change in the MCA, while adjusting for recognize d risk factors for atherosclerotic cardiovascular disease. During the 25 ye ars of followup, the MCA decreased by 22.4% in women (from 79.6 +/- 7.8 (SD ) to 61.8 +/- 10.3) and by 13.3% in men (from 80.6 +/- 6.9 to 69.9 +/- 8.3) , The aortic calcification score increased over eightfold in women (from 1. 2 +/- 2.7 (SD) to 9.9 +/- 6.7) and sixfold in men (from 1.6 +/- 2.8 to 9.6 +/- 6.3). There was a significant association between percent change in MCA and change in aortic calcification index (P = 0.01) in women after control ling for all potential confounders. No association was observed in men (P = 0.50), including the 50% of men with the greatest bone loss. This is the f irst longitudinal study to show that women with the greatest magnitude of b one loss also demonstrate the most severe progression of abdominal aortic c alcification, suggesting that the two processes may be related.