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# Osteoporosis drugs may or may not raise myocardial infarction risk
- URL: https://www.foodconsumer.org/osteoporosis_drugs_myocardial_infarction_0914120637/
- Published: 2012-09-14T19:37:00.000Z
- Updated: 2026-09-22T16:09:19.000Z
- Description: A Danish cohort of 103,562 bisphosphonate users and 310,683 matched controls tied low adherence to alendronate to roughly 50 percent higher risk of heart attack and coronary atherosclerosis, while higher adherence went with lower risk. Etidronate and raloxifene showed no such link.
- Author: Food Consumer
- Tags: Drug, Health News, #vivvo-import

By Jimmy Downs

Friday Sept 14, 2012 ([foodconsumer.org](http://www.foodconsumer.org/)) -- Patients treated with drugs for osteoporosis need to pay attention to the dose they are using. A new study in Calcified Tissue International suggests that using low doses of bisphosphonates to treat the bone disease may pose a higher risk of acute myocardial infarction or atherosclerosis of the coronary vessels, compared to using a high dose.

Peter Vestergaard the Osteoporosus Clinica, Department of Endocrinology and Internal Medicine Aarhus University Hospital THG, in Aarhus C, Denmark conducted the review study and found osteoporosis drug alendronate in low doses may pose a higher risk for myocardial infarction and atherosclerosis of the coronary vessels by about 50 percent, compared to those who tool a high dose.

Data used to establish the association and others between bisphosphonate use and risk of acute myocardial infarction or atherosclerosis of the coronary vessels came from a nationwide retrospective cohort from Denmark. The study involved 103,562 users of bisphosphonates and other medications against osteoporosis and 310,683 age- and gender-matched controls who did not take these types of medications.

Compared with those who did not take any drug against osteoporosis, overall, those who did had a higher risk for acute myocardial infarction. However, the association was not simple. A 50 percent higher risk was found among those with low adherence compared to those who were not exposed to drugs whereas those who had a higher adherence were found to have a decreased risk for acute myocardial infarction. Another two drugs etidronate and raloxifene were not found to be associated with risk of acute myocardial infarction.

Similarly, overall, those who took anti-osteoporosis drug alendronate were at higher risk for atherosclerosis of the coronary vessels, but when the drug was used in high doses, a protective effect was observed. Those who took etidronate in all doses were found at an increased risk of atherosclerosis but there was no dose–response relationship. For raloxifene, no excess risk of atherosclerosis was observed. At high doses, alendronate use was associated with a decreased risk of atherosclerosis of the coronary vessels whereas at low doses, an increased risk was found in users. 

The researchers concluded "The finding may be spurious due to the “healthy user” effect, but a causal relationship cannot be excluded.

A similar finding was reported by Taiwanese researchers in clinical Therapeutics. Py Lu of National Yang-Ming University in Taipei, Taiwan and colleagues found low doses of alendronate (10 mg) was associated with a higher risk of cardiovascular disease than alendronate (70 mg).