Parameters of arterial stiffness in patients with postmenopausal osteoporosis
DOI: 10.32364/2587-6821-2025-9-9-13
Е.С. Zhugrova1, V.I. Mazurov1, I.B. Belyaeva1, D.A. Shimansky2, V.E. Gumerova1
1North-Western State Medical University named after I.I. Mechnikov, St. Petersburg, Russian Federation
2Pavlov First Saint-Petersburg State Medical University, St. Petersburg, Russian Federation
Background: the clinical relevance of osteoporosis is primarily driven by its high prevalence among older postmenopausal women, and is defined by the occurrence of fractures. The most characteristic of these fractures are those of the proximal femur and vertebral bodies. Comorbidity and multimorbidity are becoming key challenges in internal medicine. Hypertension contributes significantly to cardiovascular disease (CVD) mortality. Osteoporosis and CVD, as age-associated pathologies, share not only similar risk factors but also common molecular pathogenic mechanisms, which ensures their bidirectional relationship. Currently, there is insufficient data available to draw definitive conclusions about the causal link between reduced bone mineral density (BMD) and the risk of CVD in women with osteoporosis.
Aim: to assess indicators of vascular stiffness in women with postmenopausal osteoporosis and determine their association with cardiovascular risks.
Materials and Methods: Within the framework of a prospective cohort study conducted during 2013–2023, two groups were formed, each consisting of 30 female patients, one group with postmenopausal osteoporosis and the other without osteoporosis. These patients had the most significant comorbid conditions: hypertension and coronary heart disease. Using blood pressure (BP) monitoring, the following peripheral BP parameters were analyzed: mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP), and mean pulse arterial pressure (PAP). Parameters of central hemodynamics and atherosclerosis were calculated by evaluating the shape of the oscillometric curve using mathematical formulas integrated into the sphygmomanometer.
Results: the Arterial Stiffness Index (ASI) and ASI normalized to SBP 100 mmHg were statistically significantly higher in patients with osteoporosis (167.5 vs 146.0; 154.0 vs 136.5, respectively). Moreover, these patients exhibited higher values for daily PAP (41.0 mmHg vs 36.0 mmHg, p<0.05) and augmentation index (19.5 vs 8.9, p<0.001) compared to patients without osteoporosis. They also showed a reduction in the subendocardial viability ratio (SEVR). In the group of patients with osteoporosis, a significant positive correlation was established between mean PAP and the Charlson Index (rs=0.917, p<0.01), the reflected wave travel time and the Charlson Index (rs=0.917, p<0.01), ambulatory ASI and the Charlson Index (rs=0.975, p<0.01), and the SEVR normalized to a heart rate (HR) of 75 bpm, and BMD L1–L4 (rs=0.917, p<0.01). Specific values mentioned: 112.7 vs 114.6; 121.6 vs 124.4, p<0.05.
Conclusion: the data obtained confirm that the pathophysiological changes in vascular tone and stiffness, as well as myocardial perfusion, identified in women with postmenopausal osteoporosis, can be viewed as independent predictors of higher cardiovascular risk. These factors must be taken into account during the stratification and management of this polymorbid patient cohort.
Keywords: vascular calcification, vascular stiffness, bone mineral density, osteoporosis, comorbidity.
For citation: Zhugrova Е.С., Mazurov V.I., Belyaeva I.B., Shimansky D.A., Gumerova V.E. Parameters of arterial stiffness in patients with postmenopausal osteoporosis. Russian Medical Inquiry. 2025;9(9):628–634 (in Russ.). DOI: 10.32364/2587-6821-2025-9-9-13
About the authors:
Elena S. Zhugrova — C. Sc. (Med.), associate professor of the E.E. Eikhvald Department of Therapy, Rheumatology, Temporary Disability Examination and Quality of Medical Care, North-Western State Medical University named after I.I. Mechnikov; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; ORCID iD 0000-0002-8622-5205
Vadim I. Mazurov — Academician of the Russian Academy of Sciences, Professor, Dr. Sc. (Med.), Honored Scientist of the Russian Federation, Chief Scientific Consultant, Director of the Research Institute of Rheumatology, Head of the Department of Therapy, Rheumatology, Examination of Temporary Disability and Quality of Medical Care with a course in Hematology and Transfusiology named after E.E. Eichwald, North-Western State Medical University named after I.I. Mechnikov; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; ORCID iD 0000-0002-0797-2051
Irina B. Belyaeva — Dr. Sc. (Med.), Professor of the E.E. Eikhvald Department of Therapy, Rheumatology, Temporary Disability Examination and Quality of Medical Care, North-Western State Medical University named after I.I. Mechnikov; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; ORCID iD 0000-0001-9126-3639
Daniel A. Shimansky — C. Sc. (Med.), assistant of the Department of Hospital Therapy with a Course of Allergology and Immunology named after Academician Chernorutsky with Clinical Department, Pavlov First Saint-Petersburg State Medical University; 6–8, Lev Tolstoy str., St. Petersburg, 197022, Russian Federation; ORCID iD 0000-0002-6903-2217
Victoria E. Gumerova — C. Sc. (Med.), assistant of the Department of Hospital Therapy and Cardiology named after M.S. Kushakovsky, North-Western State Medical University named after I.I. Mechnikov; 41, Kirochnaya str., St. Petersburg, 191015, Russian Federation; ORCID iD 0000-0003-2805-3748
Contact information: Elena S. Zhugrova, e-mail: jugrova@mail.ru
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
There is no conflict of interest.
Received 01.07.2025.
Revised 23.07.2025.
Accepted 18.08.2025.
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