Comorbidity of chronic heart failure and osteoporosis: literature review

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Abstract

The demographic aging of the population causes an increase in the number of patients with both heart failure (HF) and osteoporosis. This is due to the strengthening of disease-preventive measures, multimorbidity, and presence of comorbid conditions such as senile asthenia. As a result, these pathological conditions can cause serious consequences such as loss of functional and social activity, disability, and high rates of hospitalization and mortality. The article considers the common risk factors of HF and osteoporosis and the leading pathophysiological mechanisms underlying these conditions. Modern ideas about the causes of bone metabolism disorders and their features in patients with HF are discussed. Data on the contribution of systemic and immune inflammation, rennin-angiotensin-aldosterone system activation in the pathogenesis, and progression of HF and osteoporosis are presented. The relationship between low bone mineral density and hemodynamic disorders in patients with HF is also shown. All this is considered in the prospect of distinguishing patients with HF as a risk group for osteoporosis and patients with decreased bone mineral density as having a high cardiovascular risk.

About the authors

Vera N. Larina

Pirogov Russian National Research Medical University

Author for correspondence.
Email: larinav@mail.ru
ORCID iD: 0000-0001-7825-5597
SPIN-code: 3674-9620

MD, Dr. Sci. (Med.), Professor, department head

Russian Federation, 1 Ostrovityanova Str., 117997, Moscow

Ekaterina S. Shcherbina

Pirogov Russian National Research Medical University

Email: esscherbina@inbox.ru
ORCID iD: 0000-0001-8619-8123
SPIN-code: 6888-7050

department resident

Russian Federation, 1 Ostrovityanova Str., 117997, Moscow

Valeria V. Dryutova

Pirogov Russian National Research Medical University

Email: wpolikarpovaaaa@gmail.com
ORCID iD: 0000-0003-4894-7167
SPIN-code: 5109-6434

department assistant

Russian Federation, 1 Ostrovityanova Str., 117997, Moscow

Vladimir G. Larin

Pirogov Russian National Research Medical University

Email: larinvladimir@mail.ru
ORCID iD: 0000-0002-3177-3407
SPIN-code: 9394-2871

MD, Cand. Sci. (Med.), associate professor

Russian Federation, 1 Ostrovityanova Str., 117997, Moscow

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2. Fig. 1. Common risk factors for heart failure and osteoporosis.

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3. Fig. 2. The contribution of the renin-angiotensin-aldosterone system to impaired bone mineralization in heart failure. Note. АПФ — angiotensin-converting enzyme, ФНО — tumor necrosis factor, ПТГ — parathyroid hormone.

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