The Key To Preventing and/or Reversing Bone Loss

Women who have used Fosamax are nearly twice as
likely to develop the most common kind of
chronically irregular heartbeat (atrial fibrillation)
than are those who have never used it, according to
research from Group Health and the University of
Washington published in the April 28 Archives of
Internal Medicine.

Merck markets Fosamax, the most widely used drug
treatment for the bone-thinning disease osteoporosis,
explained study leader Susan Heckbert, MD, PhD, MPH,
a professor of epidemiology and scientific investigator
in the Cardiovascular Health Research Unit at the
University of Washington. The Food and Drug
Administration (FDA) approved the first generic
versions (called alendronate) in February.

“We studied more than 700 female Group Health
patients whose atrial fibrillation was first
detected during a three-year period,” said
Dr. Heckbert. She and her colleagues compared
those women to over 900 randomly selected female
Group Health members matched on age and high blood
pressure to serve as controls.

“Having ever used alendronate was associated with
an 86 percent higher risk of newly detected atrial
fibrillation compared with never having used the
drug,” said Dr. Heckbert, who is also an affiliate
investigator at the Group Health Center for Health
Studies.

Osteoporosis mostly affects older women and can set
the stage for fractures that can impair the quality
of their lives, said Dr. Heckbert. “Careful judgment
is required to weigh the risks and benefits of any
medication for any individual patient,” she added.
“For most women at high risk of fracture, alendronate’s
benefit of reducing fractures will outweigh the risk
of atrial fibrillation.”

However, said Dr. Heckbert, “women who are at high
risk of fractures but also have risk factors for
atrial fibrillation — such as heart failure, diabetes,
or coronary disease — might want to discuss alternatives
to alendronate with their health care providers.”
Other medications that can lower the risk of fractures
include estrogen, she said. But the Women’s Health
Initiative, on which she has also served as an
investigator, showed other heart risks from hormone
therapy combining estrogen with progesterone.

The National Heart, Lung, and Blood Institute funds
Dr. Heckbert’s Atrial Fibrillation Study, which
collects data on all Group Health patients as they
are first diagnosed with atrial fibrillation. The
study aims to find new factors that raise the risk
of developing this quivering of the heart’s upper
chambers (atria).

About one in 100 people — and nearly nine in 100
people over age 80 — have atrial fibrillation, said
Dr. Heckbert. In many cases, atrial fibrillation has
no symptoms, and it isn’t necessarily life threatening.
But it can cause palpitations, fainting, fatigue,
or congestive heart failure.

Atrial fibrillation can also make blood pool — and
sometimes clot — in the atria, said Dr. Heckbert.
When parts of clots break off and leave the atria,
they can lead to embolic strokes, as happens in
over 70,000 Americans a year. That’s why atrial
fibrillation is often treated unfortunately with
the acidic anticoagulant warfarin. Other results
from her study have suggested that maintaining a
healthy alkaline body weight may help protect
people from atrial fibrillation.

“This study will help medical teams better inform
their patients about the risks associated with Fosamax,
helping us make the best treatment decisions for
managing osteoporosis,” commented Christine Himes
Fordyce, MD, a Group Health family practitioner.
“Now with this increased understanding of potential
irregular heartbeats, both physicians and their
patients should be alert to any problems, report
them immediately, and treat them appropriately.”

According to Dr. Robert O. Young, a research
scientist at The pH Miracle Living Center,
"osteoporosis is caused by dietary and metabolic
acids. The body with waste calcium from the
bones to buffer the acids not eliminated
through urination or defecation. Bone loss
is the evidence of an over-acidic body from
an inverted way of living, eating and thinking.
The key to preventing or reversing bone loss
is to alkalize and exercise."