Research Progress of Circulatory System Diseases and Secondary Osteoporosis

doi:10.12114/j.issn.1007-9572.2024.0687

Abstract

Abstract:

Secondary osteoporosis (OP) is easy to be ignored in clinical practice, especially secondary OP caused by hypertension, coronary heart disease, chronic heart failure, atrial fibrillation and other circulatory system diseases. Due to the complexity of circulatory system diseases and adverse reactions of therapeutic drugs, the risk of secondary OP is often underestimated. Early prevention and treatment of secondary OP is very important to improve the quality of life of patients. The mechanism and treatment scheme of bone metabolism imbalance caused by different types of diseases are different. This article will review the common circulatory system diseases complicated with OP from the aspects of epidemiological characteristics, related risk factors and pathogenesis, changes of bone metabolism and characteristics of bone damage, as well as the progress of diagnosis and treatment, in order to provide reference for the prevention and treatment of circulatory system diseases complicated with OP.

Key words: Secondary osteoporosis, Osteoporosis, Hypertension, Coronary heart disease, Chronic heart failure, Atrial fibrillation, Treatment

摘要：

继发性骨质疏松症（SOP）在临床实践中容易被忽视，尤其是高血压、冠心病、慢性心力衰竭、心房颤动等循环系统疾病继发骨质疏松时，由于循环系统疾病的复杂性及治疗药物的不良反应，其继发骨质疏松的风险常被低估，及早预防和治疗SOP对于提高患者的生活质量至关重要。不同类型疾病引起骨代谢失衡的机制与治疗方案各有不同，本文将从流行病学特征、相关危险因素与发病机制、骨代谢变化与骨损害特点及诊治进展4个方面对常见循环系统疾病合并骨质疏松进行综述，以期为循环系统疾病患者合并骨质疏松防治提供参考。

关键词: 继发性骨质疏松症, 骨质疏松, 高血压, 冠心病, 慢性心力衰竭, 心房颤动, 治疗

HE Ting,LI Jia,TAN Wenbin. Research Progress of Circulatory System Diseases and Secondary Osteoporosis[J]. Chinese General Practice, 2025, 28(17): 2101-2112. DOI: 10.12114/j.issn.1007-9572.2024.0687.
贺婷,李佳,谭文彬. 循环系统疾病与继发性骨质疏松症的研究新进展[J]. 中国全科医学, 2025, 28(17): 2101-2112. DOI: 10.12114/j.issn.1007-9572.2024.0687.

Figures/Tables 1

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分类	高血压	冠心病	慢性心力衰竭	心房颤动	扩心病
增加BMD	噻嗪类利尿剂，β受体阻滞剂，ACEI，ARB，螺内酯	阿托伐他汀，辛伐他汀	β受体阻滞剂，ACEI，ARB，螺内酯	达比加群，利伐沙班，阿哌沙班	β受体阻滞剂，ACEI，ARB，螺内酯
无显著影响			SGLT2i（达格列净、恩格列净）
降低BMD	α受体阻滞剂和袢利尿剂		袢利尿剂，SGLT2i（卡格列净）	华法林	袢利尿剂

分类	高血压	冠心病	慢性心力衰竭	心房颤动	扩心病
增加BMD	噻嗪类利尿剂，β受体阻滞剂，ACEI，ARB，螺内酯	阿托伐他汀，辛伐他汀	β受体阻滞剂，ACEI，ARB，螺内酯	达比加群，利伐沙班，阿哌沙班	β受体阻滞剂，ACEI，ARB，螺内酯
无显著影响			SGLT2i（达格列净、恩格列净）
降低BMD	α受体阻滞剂和袢利尿剂		袢利尿剂，SGLT2i（卡格列净）	华法林	袢利尿剂