Osteoporosis and coronary calcium

Several studies over the years have demonstrated a curious paradox:

People with more osteoporosis (thin bones) tend to be more likely to have coronary disease (heart attacks). They also tend to have higher heart scan scores (more coronary calcification as an index of atherosclerotic plaque).

People with more coronary disease and higher heart scan scores tend to have more osteoporosis.

In other words, regardless of which way you tackle the question--osteoporosis first or heart disease first--it leads to the same conclusion: Both conditions are somehow related.

I realize I harp an awful lot on this whole vitamin D issue. But, even after correcting the vitamin D blood levels of many hundreds of people, I remain enthusiastic as ever about the untapped potential of this fascinating factor.

So I couldn't resist showing this amazing comparison of how the long-term effect can be quite graphic.

The first scan is from a 46-year old man and shows normal coronary arteries without calcium and normal density of the vertebra (a common and reliable place to measure bone density).

The second image is from a 79-year old man with both severe coronary calcification (and therefore severe coronary disease) and severe osteoporosis.

It makes you wonder if the disordered metabolism of calcium through vitamin D deficiency allows transport of calcium away from bone and into coronaries. This has, however, been shown to not be the case. Instead, they are separate processes, each under local control, but sharing a common pathophysiology (causative factors).

An intriguing question: Would the 79-year old still look like the 46-year old had he begun increasing his vitamin D intake at, say, age 30?

Comments (9) -

  • Anne

    3/4/2008 10:50:00 AM |

    Dear Dr Davis,

    Just this weekend I found this article on the web from a research scientist about vascular calcification and "osteoblast phenotype": http://www.medicine.manchester.ac.uk/postgraduate/research/studentships/nonfunded/yalexander2

    I contacted her and she told me that "resorption of bone in the skeleton co-exists with the deposition of bone in the vasculature" and sent me a diagram explaining it. She also told me that the medication I take for osteoporosis, Strontium Ranelate, which stimulates formation of osteoblasts and prevents resorption by osteoclasts, would help with vascular calcification.

    That photo of the man's osteoporosis is scary. Here's a link to one of the scans in the CT angiogram I had and now I can see the degeneration in my spine :-( And even in my sternum :-( I have been diagnosed with osteoporosis and I'm only 54 :-(


    I have no calcification in my coronary arteries but there is some on my bicuspid aortic valve...I don't think you can't see it because of all that contrast media.


  • Anonymous

    3/4/2008 1:29:00 PM |

    Perhaps it is Vitamin K (particularly K2) that is playing the role of 'traffic cop' for calcium, directing it TO bone while diverting it FROM arteries.

  • Olga

    3/4/2008 4:50:00 PM |

    Hi Dr. Davis:

    This comment is about an unrelated subject.  A well intentioned friend who is worried about my low carb life style sent me this article from the Canadian Broadcasting Corp. (CBC) website:


    The article states that "Low-fat beats low-carb in diets to reduce heart disease" as if it were a done deal.
    I was wondering what is the relevance of reduced blood flow in the arms with respect to heart disease, and if this is the only parameter they measured, as they don't supply a link to the research article.  I find it hard to believe it holds as much weight as the huge drop in triglycerides and reduction of small dense LDL particles associated with low carb vs. high carb diets.  Just curious if you had seen this article.  


  • mike V

    3/6/2008 4:05:00 AM |

    Re: Earlier post on Vitamin K

    See: "Vitamin K - Keeping Calcium in Your Bones and Out of Your Blood Vessels"

    From: WebMD

  • Stephan

    3/6/2008 8:53:00 PM |

    Hi Olga,

      I just reviewed this article on my blog.  It clearly shows LC is healthier than LF, but their interpretation of the data is WAY off base.  And interestingly, I have access to the full-length article so I saw some of the other things they measured.  Even though vascular reactivity went down in LC, vascular diameter went up.  So maybe it was just dilating less because it was already more dilated than in the LF group.

    Whole Health Source blog

  • Stan

    3/8/2008 2:54:00 AM |

    I noticed on various webmd and other fora that quite a number of long term vegetarians in their 50-ties and 60-ties seem to report osteoporosis (and coronary disease).  Q for Dr. Davis:

    - did you look at the dietary  connection among your patients, between being long term vegetarian and having higher or lower chance of osteoporosis than non-vegetarians?
    Stan (Heretic)

  • mike V

    3/10/2008 2:43:00 PM |

    It doesn't exactly answer your question, but did you read Dr D's post:

    "Should you become a vegetarian?"
    (Saturday, February 24, 2007")

  • buy jeans

    11/3/2010 2:39:23 PM |

    I realize I harp an awful lot on this whole vitamin D issue. But, even after correcting the vitamin D blood levels of many hundreds of people, I remain enthusiastic as ever about the untapped potential of this fascinating factor.

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    12/21/2010 3:27:01 PM |

    It is often said that the intake of milk ensures inflow of calcium into the body.But I have noticed that even those consuming milk in heavy doses do suffer from this problem...could you explain as to what could be the other reasons to it?