Bidirectional association between cardiovascular disease and hip fracture: a systematic review and meta-analysis

Abstract Background The aim of this study was to comprehensively analyze the bidirectional association between cardiovascular disease (CVD) and hip fracture (HF). Methods We searched PubMed, EMBASE, Web of Sciences, Cochrane Library, ScienceDirect and China National Knowledge Infrastructure for rele...

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Main Authors: Jinyi Wu, Yan Zhang, Junwen Wang, Qingsong Zhang, Jun Jiang, Qingwu Jiang, Yibiao Zhou
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-04823-4
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author Jinyi Wu
Yan Zhang
Junwen Wang
Qingsong Zhang
Jun Jiang
Qingwu Jiang
Yibiao Zhou
author_facet Jinyi Wu
Yan Zhang
Junwen Wang
Qingsong Zhang
Jun Jiang
Qingwu Jiang
Yibiao Zhou
author_sort Jinyi Wu
collection DOAJ
description Abstract Background The aim of this study was to comprehensively analyze the bidirectional association between cardiovascular disease (CVD) and hip fracture (HF). Methods We searched PubMed, EMBASE, Web of Sciences, Cochrane Library, ScienceDirect and China National Knowledge Infrastructure for relevant studies. The Newcastle-Ottawa scale was used to evaluate the risk of bias. We conducted random effects model for meta-analysis and subgroup analysis of different ethnic groups. Sensitivity analysis and publication bias of this study were also evaluated. This study followed the PRISMA and MOOSE guidelines for systematic reviews and meta-analyses. Results This research included 18 cohort studies and case-control studies with a total sample of 1,854,441 individuals. The results showed ischemic heart disease might increase the risk of HF (OR = 1.41, 95%CI[1.05, 1.89], I 2  = 96%). Stroke might be a risk factor for HF (OR = 2.23, 95%[1.18, 4.19], I 2  = 97%), and HF might likewise be a risk factor for Stroke ( OR = 2.22, 95% CI [1.81, 2.71], I 2  = 78%). Heart failure might increase the risk of HF (OR = 2.89, 95%CI [1.22, 6.85], I 2  = 91%), and HF might increase the risk of heart failure (OR = 2.74, 95%CI [1.27, 5.89], I 2  = 92%). Hypertension might increase the risk of HF (OR = 1.55, 95%CI[1.34, 1.8], I 2  = 87%), and HF might increase the risk of hypertension (OR = 3.75, 95%CI[3.3, 4.26], I 2  = 98%). Cerebrovascular disease (OR = 1.96, 95%CI[1.61, 2.4], I 2  = 79%) and diseases of arteries, arterioles, and capillaries (OR = 1.58, 95%CI[1.49, 1.68], I 2  = 0%) might increase the risk of HF. HF might increase the risk of myocardial infarction (OR = 2, 95%CI[1.17, 3.41], I 2  = 97%) and CVD-related death (OR = 1.78, 95%CI[1.05, 3.02], I 2  = 50%). Subgroup analyses showed that among Asians IHD might not raise the risk of HF (OR = 1.33, 95% CI [1.00, 1.78], I 2  = 95%). In caucasians, IHD might also not raise HF risk (OR = 1.52, 95%CI [0.64, 4.56], I 2  = 95%). Conclusions This study supports possible bidirectional associations between CVD and HF, but more mechanistic studies of CVD and HF were warranted. However, high heterogeneity and potential confounding by unmeasured variables warrant cautious interpretation.
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spelling doaj-art-a05997b43c8f47d3bfd4daa913e6552c2025-08-20T01:52:03ZengBMCBMC Cardiovascular Disorders1471-22612025-05-0125111010.1186/s12872-025-04823-4Bidirectional association between cardiovascular disease and hip fracture: a systematic review and meta-analysisJinyi Wu0Yan Zhang1Junwen Wang2Qingsong Zhang3Jun Jiang4Qingwu Jiang5Yibiao Zhou6Fudan University School of Public HealthJiading District Center for Disease Control and PreventionWuhan fourth hospitalWuhan fourth hospitalFudan University School of Public HealthFudan University School of Public HealthFudan University School of Public HealthAbstract Background The aim of this study was to comprehensively analyze the bidirectional association between cardiovascular disease (CVD) and hip fracture (HF). Methods We searched PubMed, EMBASE, Web of Sciences, Cochrane Library, ScienceDirect and China National Knowledge Infrastructure for relevant studies. The Newcastle-Ottawa scale was used to evaluate the risk of bias. We conducted random effects model for meta-analysis and subgroup analysis of different ethnic groups. Sensitivity analysis and publication bias of this study were also evaluated. This study followed the PRISMA and MOOSE guidelines for systematic reviews and meta-analyses. Results This research included 18 cohort studies and case-control studies with a total sample of 1,854,441 individuals. The results showed ischemic heart disease might increase the risk of HF (OR = 1.41, 95%CI[1.05, 1.89], I 2  = 96%). Stroke might be a risk factor for HF (OR = 2.23, 95%[1.18, 4.19], I 2  = 97%), and HF might likewise be a risk factor for Stroke ( OR = 2.22, 95% CI [1.81, 2.71], I 2  = 78%). Heart failure might increase the risk of HF (OR = 2.89, 95%CI [1.22, 6.85], I 2  = 91%), and HF might increase the risk of heart failure (OR = 2.74, 95%CI [1.27, 5.89], I 2  = 92%). Hypertension might increase the risk of HF (OR = 1.55, 95%CI[1.34, 1.8], I 2  = 87%), and HF might increase the risk of hypertension (OR = 3.75, 95%CI[3.3, 4.26], I 2  = 98%). Cerebrovascular disease (OR = 1.96, 95%CI[1.61, 2.4], I 2  = 79%) and diseases of arteries, arterioles, and capillaries (OR = 1.58, 95%CI[1.49, 1.68], I 2  = 0%) might increase the risk of HF. HF might increase the risk of myocardial infarction (OR = 2, 95%CI[1.17, 3.41], I 2  = 97%) and CVD-related death (OR = 1.78, 95%CI[1.05, 3.02], I 2  = 50%). Subgroup analyses showed that among Asians IHD might not raise the risk of HF (OR = 1.33, 95% CI [1.00, 1.78], I 2  = 95%). In caucasians, IHD might also not raise HF risk (OR = 1.52, 95%CI [0.64, 4.56], I 2  = 95%). Conclusions This study supports possible bidirectional associations between CVD and HF, but more mechanistic studies of CVD and HF were warranted. However, high heterogeneity and potential confounding by unmeasured variables warrant cautious interpretation.https://doi.org/10.1186/s12872-025-04823-4CVDHip fractureMeta-analysisSystematic reviewRisk
spellingShingle Jinyi Wu
Yan Zhang
Junwen Wang
Qingsong Zhang
Jun Jiang
Qingwu Jiang
Yibiao Zhou
Bidirectional association between cardiovascular disease and hip fracture: a systematic review and meta-analysis
BMC Cardiovascular Disorders
CVD
Hip fracture
Meta-analysis
Systematic review
Risk
title Bidirectional association between cardiovascular disease and hip fracture: a systematic review and meta-analysis
title_full Bidirectional association between cardiovascular disease and hip fracture: a systematic review and meta-analysis
title_fullStr Bidirectional association between cardiovascular disease and hip fracture: a systematic review and meta-analysis
title_full_unstemmed Bidirectional association between cardiovascular disease and hip fracture: a systematic review and meta-analysis
title_short Bidirectional association between cardiovascular disease and hip fracture: a systematic review and meta-analysis
title_sort bidirectional association between cardiovascular disease and hip fracture a systematic review and meta analysis
topic CVD
Hip fracture
Meta-analysis
Systematic review
Risk
url https://doi.org/10.1186/s12872-025-04823-4
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