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Stroke Increases Risk of Osteoporosis (dateline July 22, 2002)
Though stroke and the bone-thinning disease osteoporosis
are usually thought of as two distinct health problems, an analysis of several studies
finds a strong connection between them. Specifically, researchers have found that patients
who survive strokes are significantly more likely to suffer from osteoporosis, a disease
that puts them at high risk for bone fractures. The majority of fractures in stroke
patients occur on the side of the body that has been paralyzed from the stroke, according
to the analysis. Based on these data, the researchers suggest adding osteoporosis
treatment to stroke rehabilitation.
A stroke occurs when the supply of blood and oxygen is cut off to part of the brain. If
a portion of the brain loses its supply of nutrient-rich blood and oxygen, the bodily
functions controlled by that part of the brain (vision, speech, walking, etc.) are
impaired. Each year more than 500,000 people in the United States suffer strokes and
150,000 of those people die as a result. Risk factors for stroke include age, family
history of stroke, smoking, lack of physical activity, and high blood pressure. While the
treatment of stroke usually focuses on improving functions affected by the stroke (such as
mobility), most rehabilitation does not include the prevention of bone loss.
To better understand the connection between stroke and osteoporosis, an analysis of
several studies was conducted by Kenneth Poole, BM, MRCP and his colleagues from the
Department of Stroke Medicine and Medical Research Council Bone Research Group of
Addenbrooke’s Hospital in Cambridge. The researchers examined the risk of hip fractures in patients who had suffered strokes.
In a Swedish study, Poole and his team say that stroke patients are two to four times
more likely to suffer hip fractures than similarly aged healthy people. Another Swedish
study found that patients who suffered strokes quadrupled their risk of hip fractures
immediately after the stroke. In a separate analysis, 73% of 108 stroke patients were
found to have fallen within six months of suffering a stroke. Falling is a significant
risk factor for hip fractures, especially among elderly people. The average age of a
stroke victim is 70, according to Poole and his colleagues.
The analysis also found that patients who suffered strokes were more likely to die from
hip fractures or experience a reduced quality of life compared to similarly aged healthy
people. Since the majority of stroke patients are already have an elevated risk of
osteoporosis due to their age, the immobility caused by a stroke can lead to a
substantially increased risk of bone fractures among these patients.
Therefore, Poole and his colleagues suggest that stroke patients be treated
aggressively to help prevent the potentially devastating effects of osteoporosis. The
researchers suggest the use of drugs called bisphosphonates early during stroke
rehabilitation. Bisphosphonates such as Fosamax
(generic name, alendronate) or Actonel
(generic name, risedronate sodium) are non-hormonal therapies that help increase bone
mineral density, which can prevent bone fractures. Because the pill forms of these drugs
require that patients remain in an upright position for at least 30 minutes after taking
them, the researchers say the drugs would most likely have to be administered
intravenously (through a vein) in stroke patients.
Other methods of treating osteoporosis include:
- Changing diet to include more calcium and vitamin D
- Increasing physical activity
- Hormone replacement therapy (HRT)
- Other drug therapies, such as Evista
(generic name, raloxifene) or Miacalcin
(generic name, calcitonin)
Additional Resources and References
- The report, "Falls, Fractures, and Osteoporosis After Stroke, Time to Think About
Protection?" is published in the May 2002 issue of Stroke: Journal of the American
Heart Association, http://stroke.ahajournals.org/
- The May 3, 2002 American Heart Association report, "Stroke Survivors Have
Brittler Bones, More Likely to Fracture," is available at http://www.americanheart.org/
- To learn more about stroke, please visit http://www.imaginis.com/stroke/
- To learn more about osteoporosis, please visit http://www.imaginis.com/osteoporosis/
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