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Osteoporosis medication promotes cardiovascular health in postmenopausal women

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Earlier this month, a study by researchers at University of Southern California’s (USC) Keck School of Medicine reported that removal of the ovaries at the time of a hysterectomy resulted in bone loss and an increased risk of cardiovascular disease. A study published by Japanese researchers on February 17 in the journal Menopause reported that bisphosphonates, which are used to treat osteoporosis, can promote cardiovascular health.

The researchers note that osteoporosis and atherosclerosis (formation of plaques within the arteries) are the two most common diseases in postmenopausal women. Usually, both diseases are simultaneously present in the same woman and commonly lead to bone fracture or cardiovascular disease. Bisphosphonates are often used in the treatment of osteoporosis because they can increase bone mineral density; thus, reducing the risk of osteoporosis. In addition, studies have suggested that bisphosphonates may also protect against cardiovascular disease. Minodronate is now commonly given once a month in a 50 milligram dose and researchers anticipate that it might protect against both osteoporosis and cardiovascular disease. They note that a useful method for predicting cardiovascular disease is brachial-ankle pulse wave velocity (baPWV). Therefore, they used the procedure to directly compare the effects of monthly minodronate (50 mg) with those of a standard single weekly 35 mg dose of alendronate (Fosamax) on the bone mineral density of the lower spine on bone mineral density and baPWV in postmenopausal women with osteoporosis over a 12 month period.

The study group comprised 38 postmenopausal women with osteoporosis who were randomly assigned into two treatment groups: group 1 received weekly alendronate (19 women); group 2 received monthly minodronate (19 women). Lower spine bone mineral density and baPWV were measured at study enrollment and after 12 months of treatment.

The investigators found that at the end of the 12 month period, increases in lower spine bone mineral density were similar between the two groups; however, baPWV was significantly reduced in the minodronate group, compared to the alendronate group (a lower baPWV indicates healthier arteries). In addition, the change in baPWV during the study period inversely correlated with the change in lower spine mineral density, meaning that as the bone mineral density increased the elasticity of the arteries improved.

The authors concluded that changes in lower spine bone mineral density in the monthly minodronate and weekly alendronate groups were similar. They noted that good control of changes in lower spine bone mineral density in postmenopausal women might be associated with reversal of cardiovascular disease. They added that monthly minodronate is a promising new bisphosphonate and potential first-line medication for the treatment of osteoporosis in postmenopausal women.