A clinical diagnosis of thin and brittle bones in women is strongly linked to adverse health events from atherosclerosis, or hardening and narrowing of the arteries, according to a new study.

Weaknesses in certain bones in particular appeared to signal heightened risk of heart attack and stroke, reported senior author Goo-Yeong Cho, M.D., Ph.D., of Seoul National University College of Medicine, in South Korea. 

Cho and colleagues analyzed medical records from more than 12,600 women aged 50 to 80 years who had dual-energy X-ray absorptiometry, or DXA, scans to determine bone density. Over an average follow-up of nine years, almost 4% (468) of the women experienced adverse health events linked to atherosclerotic cardiovascular disease. Another 2% (237) died from these events, they reported.

Thinner lower-spine, hip and upper thigh bones were independently associated with a 16% to 38% risk of heart attack or stroke. That’s after accounting for other potentially influential factors including age, high blood pressure, high cholesterol, smoking and previous fractures. 

In addition, a clinical diagnosis of osteoporosis was independently found to be associated with higher risk for artherosclerotic events, the authors said.

People with osteoporosis often have atherosclerosis, noted Cho. Although the reasons why are not yet known, it appears that clinical risk factors alone do not as accurately predict atherosclerosis-related risk as they do when combined with bone mineral density scores or a diagnosis of osteoporosis, he and his colleagues wrote.

“Considering that [DXA scanning] is widely used to screen for osteopenia and osteoporosis in asymptomatic women, the significant association between [bone mineral density] and higher risk of [cardiovascular disease] provides an opportunity for large-scale risk assessment in women without additional cost and radiation exposure,” the authors concluded.

Full findings were published in the BMJ