A new study from Tulane University finds that postmenopausal women with higher cardiovascular risk face significantly greater odds of fractures, especially hip fractures. Using the American Heart Association’s PREVENT score, researchers tracked more than 21,000 women and found risk nearly doubled in high-risk groups. The findings suggest heart health metrics could help flag fracture risk earlier, though more research is needed.
A routine heart risk assessment may offer clues about something far beyond the heart.
Researchers at Tulane University report that postmenopausal women with elevated cardiovascular risk are significantly more likely to suffer major bone fractures, including hip injuries that often lead to long-term disability [1]. The study, published in The Lancet Regional Health – Americas, analyzed data from more than 21,000 participants in a long-running U.S. health study
For women already navigating the health changes of menopause, the findings point to a deeper biological connection between heart health and bone strength.
PREVENT score study shows strong link between heart risk and fractures
The researchers used the American Heart Association’s PREVENT score, a tool designed to estimate a person’s 10-year risk of cardiovascular disease, to group women into risk categories ranging from low to high
Women in the highest cardiovascular risk group had a 93 percent greater risk of hip fracture compared with those in the lowest-risk group. Those in the intermediate category faced a 33 percent higher risk
The association extended beyond hip fractures. Elevated cardiovascular risk also correlated with fractures in other major areas such as the spine, forearm and shoulder, particularly in bones weakened by osteoporosis.
“We were surprised by the magnitude associated with hip fracture risk,” said Rafeka Hossain, lead author of the study and a researcher at Tulane University School of Medicine
The connection appeared strongest in women under 65, suggesting that cardiovascular risk may signal vulnerability earlier than traditional fracture screening tools detect.
Why heart health and bone health may be connected
Scientists have long observed overlaps between cardiovascular disease and bone loss, but the mechanisms remain under investigation.
The new study adds weight to the idea that shared biological processes may drive both conditions. Researchers point to chronic inflammation, oxidative stress and disruptions in calcium regulation as possible links.
Reduced blood flow to bones due to atherosclerosis, a condition marked by plaque buildup in arteries, may also weaken bone structure over time. Hormonal shifts after menopause, especially declining estrogen levels, can further increase risk for both heart disease and osteoporosis.
An estimated one in three women over age 50 will experience a fracture related to bone loss in their lifetime, underscoring the scale of the issue
Earlier fractures seen in high-risk cardiovascular group
The study also found differences in how quickly fractures occurred.
Among women classified as high cardiovascular risk, hip fractures happened sooner, with a median time of about 15 years. In contrast, women in the low-risk group experienced fractures closer to 20 years on average
That gap suggests cardiovascular risk may not only increase the likelihood of fractures but also accelerate their onset.
What the findings could mean for screening and prevention
Researchers say the PREVENT score, developed by the American Heart Association in 2024, could eventually serve as an additional tool to identify women who may benefit from bone density testing or specialist referral
For now, standard fracture risk tools remain the primary method for clinical decision-making. The study’s authors caution that more research is needed before cardiovascular risk scores are incorporated into routine bone health screening.
Still, the overlap between the two conditions opens the door to more integrated prevention strategies.
“Many of the same factors that protect your heart also help protect your bones,” Hossain said, citing exercise, diet, smoking cessation and management of chronic conditions such as diabetes and high blood pressure
A growing focus on whole-body risk in aging women
The findings reflect a broader shift in medicine toward understanding how systems in the body interact rather than treating conditions in isolation.
Cardiovascular disease and osteoporosis are both common, costly and often silent until serious events occur. Identifying shared risk factors could allow clinicians to intervene earlier and more effectively.
For postmenopausal women, the message is less about adding new tests and more about connecting existing ones.
A heart risk score, long used to prevent heart attacks and strokes, may also offer a window into bone health.
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