医药导报2026，Vol.45Issue(4)：685-693,9.DOI:10.3870/j.issn.1004-0781.2026.04.018
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
Cardiovascular Safety Management of Therapeutic Agents for Senile Osteoporosis:Current Status and Future Challenges
张思晨 1杜光心 1龙萍1
作者信息
- 1. 泰康同济(武汉)医院药学部,武汉 430050
- 折叠
摘要
Abstract
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.关键词
抗骨质疏松药物/老年骨质疏松症/心血管安全性/个体化治疗Key words
Anti-osteoporosis drugs/Senile osteoporosis/Cardiovascular safety/Individualized therapy分类
医药卫生引用本文复制引用
张思晨,杜光心,龙萍..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[J].医药导报,2026,45(4):685-693,9.
