Postmenopausal women with higher risk of cardiovascular disease are more likely to experience hip and other major bone fractures, according to a study published by Tulane University on Mar. 27.
The research highlights the importance of monitoring both heart and bone health after menopause, as declines in estrogen levels can increase the risk of osteoporosis and related fractures. The study found that an estimated one in three women over age 50 will have a fracture due to bone loss during their lifetime.
Researchers used the American Heart Association's PREVENT score, developed in 2024, to estimate participants' 10-year cardiovascular disease risk. Women were grouped into low, borderline, intermediate or high-risk categories. The strongest association was seen with hip fractures: those in the high-risk group had a 93% higher chance of hip fracture compared to low-risk women; intermediate-risk individuals had a 33% greater chance. Higher cardiovascular risk also correlated with increased likelihood of fractures at other major sites such as the spine, forearm or shoulder.
Lead author Rafeka Hossain from Tulane University School of Medicine said, "While previous studies have suggested a link between cardiovascular disease and fracture risk, we were surprised by the magnitude associated with hip fracture risk." Hossain added that reducing risks for both conditions could improve quality of life for older adults.
The findings come from data on more than 21,000 participants enrolled in the Women's Health Initiative study. Researchers suggest several biological processes may explain the connection between heart health and bone strength—including chronic inflammation and hormonal changes after menopause that affect both systems simultaneously.
"Many of the same factors that protect your heart—regular physical activity, a balanced diet rich in calcium and vitamin D, not smoking and managing conditions like diabetes and high blood pressure—also help protect your bones," Hossain said. She encouraged postmenopausal women at intermediate or high cardiovascular risk to discuss bone health screening options with their doctors.
Women classified as high-risk tended to experience fractures sooner than those at lower risk; for example, median time until hip fracture was about five years earlier among those at highest cardiac risk. Although researchers say more work is needed before using cardiovascular scores routinely for fracture screening decisions, they advise women with elevated cardiac risks after menopause consider proactive conversations about bone health care.
"Taking care of your heart and bones should go hand in hand," Hossain said.
