老年骨质疏松症治疗药物的心血管安全性管理:现状与未来挑战OA

Senile osteoporosis and cardiovascular disease exhibit significant comorbidity,and the cardiovascular safety of anti-osteoporosis drugs poses a critical challenge in clinical decision-making.This article systematically reviews the potential cardiovascular impacts of four major classes of drugs(encompassing six specific agents)used for treating senile osteoporosis,cat-egorized by mechanism,aiming to provide evidence-based guidance for safe pharmacotherapy in elderly osteoporotic patients.Evi-dence synthesis from the past five years identified that bisphosphonates show inconclusive cardiovascular protective effects,though intravenous formulations may increase atrial fibrillation risk;denosumab is associated with elevated risk of adverse cardiovascular events compared to bisphosphonates;selective estrogen receptor modulators increase venous thromboembolism and fatal stroke risks,yet may confer indirect cardiovascular benefits via lipid profile improvement;parathyroid hormone analogs require vigilance for transient dizziness and palpitations;romosozumab may heighten ischemic risk in cardiovascularly vulnerable populations,ne-cessitating rigorous clinical history evaluation;excessive calcium supplementation(>1 200 mg/day)remains controversial for cardiovascular risk,while standard-dose vitamin D has not been consistently linked to significant cardiovascular harm.Elderly osteoporotic patients require individualized balancing of skeletal benefits against cardiovascular risks.