ALLERGY, RESPIRATORY
Air Quality Better in Northeast, Midwest
New Spray Could Benefit Cystic Fibrosis Patients
Asthmatics Who Quit Smoking May Reverse Lung Damage
ALTERNATIVE MEDICINE
New Insights Show Ginseng Fights Inflammation
Ginger Can Ease Nausea From Chemotherapy Treatments
Birds Don't Miss a Beat
ANIMAL CARE
Separation Anxiety, Canine-Style
Animals Respond to Acupuncture's Healing Touch
'Comfort Dogs' Come to Emotional Rescue
BONES & JOINTS
Cane Use May Cut Progression of Knee Osteoarthritis
Scientists Discover How Osteoarthritis Destroys Cartilage
Tequila Plant May Help Fight Bone Loss
CANCER
Supplements Might Reduce Breast Cancer Risk
Sharing Cancer Info May Be Empowering
Minorities Distrust Medical System More
CAREGIVING
Mom's Smoking May Lead to SIDS
Caring for Aging Loved Ones Can Be a Catch-22
When the Caregiver Becomes the Patient
CIRCULATORY SYSTEM
Potassium-Rich Foods May Cut Stroke, Heart Disease Risk
An Apple a Day May Help Keep Heart Disease Away
Vitamins Do Older Women Little Good
COSMETIC
New Genetic Links to Baldness Discovered
Gum Chewing May Cut Craving for Snacks
With Psoriasis, the Internet May Offer Hope
DENTAL, ORAL
An Oral Approach to Heart Disease
Health Tip: At Risk for Gingivitis
Gum Disease May Reactivate AIDS Virus
DIABETES
Fructose-Sweetened Drinks Up Metabolic Syndrome Risk
Older Diabetics With Depression Face Higher Death Rate
Diabetes Linked to Cognitive Problems
DIET, NUTRITION
Eating Well And Keeping Active As You Grow Old Will Help You Stay Sharp
Many Cancer Survivors Don't Adopt Healthy Lifestyle
Caffeine May Offer Some Skin Cancer Protection
DISABILITIES
Review Finds Marijuana May Help MS Patients
Could Your Cell Phone Help Shield You From Alzheimer's?
ENVIRONMENTAL HEALTH
Stomach Germ May Protect Against Asthma
Old-Growth Forests Dying Off in U.S. West
Preparing for a Chlorine Gas Disaster
EYE CARE, VISION
Eye Test Could Spot Diabetes Vision Trouble Early
'Blind' Man Navigates Obstacle Course Without Error
Music Can Help Restore Stroke Patients' Sight
FITNESS
Diet, Exercise May Slow Kidney Disease Progression
School Phys. Ed. Injuries Up 150 Percent
Fliers Can Keep Blood Clots at Bay
GASTROINTESTINAL PROBLEMS
Soothing Imagery May Help Rid Some Kids of Stomach Pain
Traditional Nonsurgical GERD Treatments Not Impressive
Bowel Prep Harder on Women Than Men
GENERAL HEALTH
A Honey of a Sinusitis Treatment
Dr Churchill & Ashley Pelton Interview 1 of 4
Laugh and the World Understands
HEAD & NECK
Zen May Thicken Brain, Thwart Pain
Many Children Will Outgrow Headaches
Ski Helmets Encouraged for All
HEALTH & TECHNOLOGY
Combating Myths About Seasonal Allergies
Imaging Sheds Light on How Acupuncture Works
The Internet Is Becoming One-Stop Shopping for Health Help
HEARING
Noise Hurts Men's Hearing More, Study Shows
Summer Sounds Can Lead to Hearing Loss
HEART & CARDIOVASCULAR
Whole Grains Lower Risk of Heart Failure
Most Fast-Food French Fries Cooked in Unhealthiest Oil
Toothbrushing May Stave Off Heart Woes
INFECTIOUS DISEASE
Bacterial Infections May Succumb to Honey
Swine Flu Now Reported in All 50 States
Swine Flu Closes Three Schools in NYC
INFERTILITY
Obesity May Affect Fertility in Young Womene
KID'S HEALTH
Teen Stress May Have Roots in First Three Years of Life
Stomach Germ May Protect Against Asthma
Soothing Imagery May Help Rid Some Kids of Stomach Pain
MEN'S HEALTH
Eating Fast Until Full Triples Overweight Risk
Strenuous Daily Workout May Keep Cancer at Bay
Physical Activity May Prolong Survival After Colon Cancer
MENTAL HEALTH
A Simple 'Thank You' Brings Rewards to All
Keeping Mentally Active Seems To Keep The Brain Active
17 Ways to Create the Perfect Workday
PAIN
Alleviating Rheumatoid Arthritis
Tai Chi May Help Ease Fibromyalgia
Are We Exercising Pain Away? Not So Much.
PHYSICAL THERAPY
PREGNANCY
Acupuncture May Ease Depression During Pregnancy
Prenatal Stress May Boost Baby's Asthma Risk
Alternative Treatments May Boost IVF Success
SENIORS
Boost In Elderly Population Will Be Felt Worldwide
Any Old Cane Won't Do
Friends, Not Grandkids, Key to Happy Retirement
SEXUAL HEALTH
SLEEP DISORDERS
Better Sleep, Grades Seem to Go Up
Pay Attention to Signs That Say You're Too Fatigued to Drive
6 to 8 Hours of Shut-Eye Is Optimal for Health
WOMEN'S HEALTH
Green Tea May Help Treat Uterine Fibroids
Being Active an Hour a Day Puts Brakes on Weight Gain
Acupuncture May Ease Depression During Pregnancy
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Heart Failure Raises Risk of Fractures

MONDAY, Oct. 20 (HealthDay News) -- People with heart failure face a higher risk of fractures, particularly of potentially crippling breaks in the hip bones, new Canadian research finds.

The study of more than 16,000 heart disease patients treated at emergency rooms in the province of Alberta found a more than fourfold higher incidence of fractures among the 2,000 of them with heart failure. The report is in the Nov. 4 issue of Circulation.

Overall, 4.6 percent of those with heart failure, the progressive loss of the heart's ability to pump blood, had broken bones in the year after the emergency room visit, compared to only 1 percent of people with other heart conditions. The one-year rate for hip fractures was 1.3 percent for those with heart failure, compared to 0.1 percent of those with other heart conditions.

While a 1997 study found a hint of low bone density among people getting heart transplants because of heart failure, "this is the first large-scale study of heart failure and fracture rate," said study author Dr. Justin A. Ezekowitz, director of the Heart Function Clinic at the University of Alberta, in Edmonton.

The finding has several important implications for people with heart failure and the doctors who treat them, Ezekowitz said. The higher incidence of hip fractures is especially worrying, he said, since, "they can be seriously debilitating for older folks, increasing the risk of blood clots to the legs and development of pneumonia."

"First, we need appropriate treatment of osteoporosis for patients with heart failure," Ezekowitz said. "Second, we need to encourage heart failure patients to maintain exercise and good nutrition."

Osteoporosis is loss of bone mass that increases the risk of fracture. Exercise and proper dieting are recommended to help prevent the condition.

It's not clear why heart failure should lead to weaker bones, Ezekowitz said. One theory is that the diuretic drugs often prescribed for people with heart failure might be bad for the bones, he said. Another possibility is the higher level of parathyroid hormone, which handles calcium and magnesium, often seen in heart failure could have a bone-weakening effect.

Physicians treating people for heart failure need to be more aware of the risk of fractures, said Dr. Mariell L. Jessup, director of the heart failure and transplant program at the University of Pennsylvania and a spokeswoman for the American Heart Association.

"When patients have such a severe disease, we tend to ignore the other problems they might have," Jessup said. "There is good reason to focus on the total patient, and not just their heart failure."

Awareness of the vitamin D status of someone with heart failure is important, both Jessup and Ezekowitz said. Vitamin D is directly involved in bone strength. But both expressed doubts about using vitamin D supplements specifically for heart failure patients.

"People should be on vitamin D supplements according to the guidelines for osteoporosis care," Ezekowitz said. "There haven't been a lot of clinical trials testing vitamin D supplements in heart failure patients."

Asked about vitamin D, Jessup said, "I treat heart disease. I leave that question to the endocrinologists."

-Ed Edelson

More information

Heart failure is described by the American Heart Association.



SOURCES: Justin A. Ezekowitz, director, Heart Function Clinic, assistant professor, medicine, University of Alberta, Edmonton, Canada; Mariell L. Jessup, professor, medicine, and director, heart failure and transplant program, University of Pennsylvania, Philadelphia; Nov. 4, 2008, Circulation

Last Updated: Oct. 20, 2008

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