Osteoporosis Drugs Increase Risk For Heart Problems

People who take bisphosphonates
for osteoporosis may be at risk for serious atrial fibrillation (AF), or
irregular heartbeats, according to a new study. The research, presented at
CHEST 2008, the 74th annual international scientific assembly of the
American College of Chest Physicians (ACCP), shows that people taking
alendronate or zoledronic acid, two common medications to prevent or slow
the occurrence of osteoporosis, were significantly more likely to
experience serious AF, including hospitalization or death, compared with
placebo.



"Atrial fibrillation can be serious if it is persistent or occurs in
people with preexisting heart disease or hypertension," said Jennifer
Miranda, MD, Jackson Memorial Hospital, Miami, FL. "If left untreated, it
can lead to pulmonary edema, congestive heart failure, or the formation of
a blood clot that can cause a brain embolism and stroke."



In a metaanalysis, Dr. Miranda and colleagues from the University of
Miami evaluated the relationship between the use of bisphosphonates and AF,
a condition that can produce a wide range of symptoms, including
light-headedness, palpitations, chest pain, and shortness of breath, or no
symptoms at all. Three studies met eligibility criteria and included a
total of 16,322 patients, of whom 76 to 100 percent were women using
bisphosphonates for osteoporosis with a mean age range 69 to 75 years.
Patients in the study were taking alendronate or zoledronic acid. The
analysis showed that 2.5 to 3 percent of patients taking bisphosphonates
experienced atrial fibrillation and 1 to 2 percent experienced serious AF,
including hospitalization or death. Patients taking bisphosphonates were
more likely to experience AF than patients receiving placebo and up to two
times more likely to experience serious AF than patients receiving placebo.



"In patients with increased risk factors for atrial fibrillation,
clinicians should be more cautious when choosing treatment for osteoporosis
and weigh the risks against the benefit of decreased fracture risk," said
Dr. Miranda.



"Bisphosphonates are widely used to treat millions of women and men who
suffer from osteoporosis or low bone density," said James A. L. Mathers,
Jr., MD, FCCP, President of the American College of Chest Physicians. "A
potential link between bisphosphonates and atrial fibrillation warrants
additional research in this area."



CHEST 2008 is the 74th annual international scientific assembly of the
American College of Chest Physicians, held October 25-30 in Philadelphia,
PA. ACCP represents 17,000 members who provide patient care in the areas of
pulmonary, critical care, and sleep medicine in the United States and
throughout the world. The ACCP's mission is to promote the prevention and
treatment of diseases of the chest through leadership, education, research,
and communication. For more information about the ACCP, please visit the
ACCP Web site at chestnet.


American College of Chest Physicians

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