Prevalence of Osteoporosis in Postmenopausal Women with Cardiovascular Comorbidities: A Cross-Sectional Study

Background: Osteoporosis and cardiovascular disease (CVD) are major health concerns in postmenopausal women. Both conditions share overlapping risk factors such as aging, estrogen deficiency, sedentary lifestyle, and metabolic disturbances. However, data on the coexistence of osteoporosis and CVD in South Asian populations remain limited. Objective: To determine the prevalence of osteoporosis among postmenopausal women with cardiovascular comorbidities and to evaluate the association between bone health and metabolic as well as clinical risk factors. Methods: This descriptive cross-sectional research was carried out at two tertiary care facilities in Punjab, Pakistan, between March 2024 and April 2025. Purposive sampling was used to recruit 100 postmenopausal women between the ages of 50 and 75 who had at least one cardiovascular comorbidity, such as hypertension, ischemic heart disease, or chronic heart failure. Anthropometric measures, clinical history, and demographic information were documented. Dual-energy X-ray absorptiometry (DEXA) was used to quantify bone mineral density (BMD) at the lumbar spine and femoral neck. The results were classified based on WHO guidelines. Serum calcium, vitamin D, lipid profile, fasting blood glucose, and HbA1c were measured. Chi-square tests and logistic regression were used in the statistical study to find osteoporosis predictors. Results: The prevalence of osteoporosis was 48%, while 32% had osteopenia and 20% normal BMD. Osteoporosis was more common in women with ischemic heart disease (57.1%) compared with hypertension (45.8%) and chronic heart failure (46.2%). Poor glycemic control (HbA1c >7%), vitamin D deficiency, and uncontrolled systolic hypertension were significantly associated with osteoporosis. Independent predictors included age ≥65 years, diabetes mellitus, menopause >15 years, and vitamin D deficiency. Conclusion: Osteoporosis is highly prevalent in postmenopausal women with cardiovascular comorbidities. Integrated screening and management of skeletal and cardiovascular risk factors are essential to reduce morbidity and improve quality of life in this high-risk group.