Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
Womens Health (Lond). 2023 Jan-Dec;19:17455057231165549. doi: 10.1177/17455057231165549.
There is mounting evidence of an association between osteoporosis and cardiovascular disease that extends beyond shared risk factors for these conditions. In turn, the medications used to treat each of these conditions can have effects that impact the other organ system: medications used in heart disease have the potential to affect bone health, while osteoporosis medications may modify cardiovascular health. While data in this subject area are limited by the paucity of large randomized controlled trials with bone mineral density or fracture risk as primary outcomes, this review explores the data available that can provide some insight into these reciprocal effects of medications on bone and heart health. Data on bone health effects of the loop and thiazide diuretics, beta blockers, calcium channel blockers, statins, warfarin, sodium-glucose cotransporter 2 inhibitors, metformin, and medications impacting the renin-angiotensin-aldosterone system are examined; the cardiovascular effects of osteoporosis therapies and vitamin D are also discussed. Importantly, while most data in this realm are inconclusive, recognizing the parallels between cardiovascular and bone disorders and how this is reflected in medication effects might prompt the clinician to consider the indirect impact of drug regimens when making therapeutic choices for patients with osteoporosis and heart disease.
越来越多的证据表明，骨质疏松症和心血管疾病之间存在关联，这种关联超出了这两种疾病的共同风险因素。反过来，用于治疗这两种疾病的药物可能会对其他器官系统产生影响：用于治疗心脏病的药物有可能影响骨骼健康，而骨质疏松症药物可能会改变心血管健康。尽管该领域的数据受到缺乏以骨密度或骨折风险为主要结局的大型随机对照试验的限制，但本综述探讨了可用的数据，这些数据可以为药物对骨骼和心脏健康的相互影响提供一些见解。检查了利尿剂、β受体阻滞剂、钙通道阻滞剂、他汀类药物、华法林、钠-葡萄糖共转运蛋白 2 抑制剂、二甲双胍以及影响肾素-血管紧张素-醛固酮系统的药物对骨骼健康的影响；还讨论了骨质疏松症治疗和维生素 D 的心血管作用。重要的是，尽管该领域的大多数数据尚无定论，但认识到心血管疾病和骨骼疾病之间的相似之处，以及这如何反映在药物作用中，可能会促使临床医生在为骨质疏松症和心脏病患者做出治疗选择时，考虑药物治疗方案的间接影响。
