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How osteoporosis affects the blood vessels of the heart?
Drugs for treating osteoporosis can also improve coronary artery calcification.
1. Osteoporosis: Loss of calcium from bones
Bones are an important part of our human body. The flexible coordination of 206 bones allows us to move freely. The rigid skeleton also constitutes a strong protective umbrella for the whole body’s internal organs. However, the bone is not a solid steel tube, it is not only strong but also light and flexible.
A normal bone is like a house. The raw material is calcium salt, but the surface layer is strong cortical bone, with high density and hardness, just like the wall of a steel pipe. The middle part is relatively small in density of cancellous bone, consisting of countless bones.
The bone trabeculae are arranged crosswise and connected. This overall structure of hard outside and loose inside satisfies the above-mentioned human biomechanical needs to the greatest extent.
To build each bone, we need two kinds of cells in our body: osteoblasts and osteoclasts. The former is an architect: responsible for adding new calcium to the bones; the latter is a demolition worker: removing excess calcium from the house .
Of course, if this balance is broken and the function of osteoclasts becomes stronger, there will be fewer “house beams” and the whole house will be more unstable.
As more calcium salts are released from the bones into the blood, the bones The strength will be significantly reduced, which is what we call “osteoporosis”.
The entire bone is like a porous hornet’s nest. A slight movement may be too heavy for the fragile bones to bear, causing joint pain. In severe cases, even fractures may occur. .
2. Coronary artery calcification: calcium deposits in the coronary artery
Osteoporosis is essentially a breakdown of the balance between calcium osteogenesis and osteoclastosis. Calcium metabolism is disturbed, and more calcium salts are lost to the blood.
Arteries, as channels for blood circulation, have also become sites where calcium salts are easily deposited.
When calcium salt is deposited in the coronary blood vessels, it will cause coronary artery stenosis, which is what we commonly call “coronary heart disease” and “angina pectoris“. The most dangerous thing is myocardial infarction, causing many people to lose their lives in silence.
1) From coronary artery sclerosis to coronary artery calcification, the degree of risk increases
In the study scientists found that coronary heart disease, coronary artery stenosis is a long process, minutes before the late 3 stages, initially to complex carbohydrates cholesterol and aggregate to form a “soft patch,” which, after the mid-vessel wall injury and more Thrombus formation, calcification deposition and infarction in the later stage.
When the calcium in the blood combines with phosphorus to form hydroxyapatite and deposits in the blood vessels, hard calcified plaques are formed. Calcified plaque is not easy to dissolve, and it will continue to grow like bones, which will narrow the coronary artery until it is completely occluded, and then the probability of causing myocardial infarction will increase exponentially.
2) Coronary artery calcification is insidious and severe, and the stenosis is severe when found
With the deposition of calcium salts in coronary plaques, the overall plaques will become more solid “hard structures”. Chronic coronary calcification will make the plaques more stubborn, like a stubborn stone, which is difficult to be taken orally against platelets. Drug removal.
This type of patients has more than 70% or even 90% of the vascular stenosis without showing symptoms. If there is no pain, it is less likely to find coronary heart disease and will not go to the hospital for treatment. When they first see a doctor, they are often already suffering from acute myocardial infarction and dying. .
3) Coronary artery calcification is stubborn and difficult, and the treatment is not effective
Compared with non-calcified or slightly calcified lesions, PCI treatment of severely calcified lesions may cause more surgical complications (such as coronary dissection, perforation, etc.), leading to more major adverse cardiac events ( MACE ); calcified lesions are likely to cause Insufficient stent expansion and poor adherence can further increase the risk of in-stent restenosis ( ISR ) and stent thrombosis ( ST ).
Severely calcified lesions can also cause difficulties in the delivery of the balloon or stent, thus making it impossible to complete PCI . Moreover, even if the stent can barely pass through the calcification, the polymer coating of the stent will inevitably not be damaged, so that the drug cannot fully act on the calcified lesion. Place.
Although at present, our domestic cardiologists have developed rotational atherectomy and laser techniques for coronary artery calcification lesions, coronary artery calcification is still a very difficult type of coronary heart disease to treat. Early warning and early treatment are the best ways to deal with coronary artery calcification.
3. Osteoporosis and coronary heart disease: mutual influence, mutual warning
As early as decades ago, American scholars discovered when studying mineral metabolism in the human body that osteoporosis and vascular calcification are common symptoms of mineral metabolism disorders.
A study found that arterial calcification is closely related to the decrease in bone density and calcium loss of the proximal femur. The bones are thought to have an invisible thread directly connected to the blood vessels. Any abnormality in either side will affect each other.
1) Blood vessel sclerosis and bone growth have similarities
Studies have pointed out that there are osteoblast-like cells and osteoclast-like cells that can express related proteins similar to ossification-related signal transduction pathways in atherosclerotic plaques to promote the differentiation of osteocytic-like cells.
Monocyte – macrophages can pass The release of inflammatory factors such as tumor necrosis factor alpha, IL-1B and IL-6 induces vascular smooth muscle cells to differentiate into osteoblast-like cells; bone cells can also secrete a variety of regulatory factors to participate in the formation of vascular calcification.
In addition, some lipid metabolites can also affect cardiovascular and bone growth at the same time.
2) Drugs for treating osteoporosis can also improve coronary artery calcification
Vitamin K2 promotes calcium metabolism. Studies have confirmed that vitamin K can act on osteoblasts and promote bone tissue calcification. At the same time, it can also inhibit osteoclasts from causing bone resorption, thereby increasing bone density. It can not only prevent but also treat osteoporosis.
Some countries have approved the official use of vitamin K as a treatment for osteoporosis in clinical practice. Studies have found that vitamin K2 can reduce the production of reactive oxygen species and inhibit vascular calcification through anti-oxidative stress.
Vitamin K2 supplementation can inhibit the development of aortic calcification in mice.
Coronary heart disease and osteoporosis are two common diseases in our society. In recent years, the incidence of these two diseases has increased significantly, and there is a clear trend of younger generation.
With the unremitting efforts of orthopedics and cardiology experts and scholars, the similarities between the pathogenesis of these two diseases have been gradually revealed, and considerable progress has been made in drug treatment and disease prevention.
It is recommended that readers and friends should fully understand the correlation between these two diseases. Early diagnosis, early prevention, and early treatment can promptly eliminate life-threatening or quality-of-life diseases before “being sick”.
How osteoporosis affects the blood vessels of the heart?
(source:internet, reference only)