Coronary artery calcium and bone mineral density by serial CTA: Does menopausal hormone therapy modify the association?

•Osteoporosis (ie, reduced bone mass and micro architectural deterioration) and coronary artery disease (CAD) are age related conditions associated with significantly high morbidity and mortality in post-menopausal women.•Women with osteoporosis and osteopenia are more prone to atherosclerotic cardiovascular disease compared with women without this condition.•Increased mortality rates due to cardiovascular disorders have been observed in postmenopausal women with low BMD.•Therefore, in postmenopausal women diagnosed with osteoporosis, it is critical to consider not only clinical management for fracture prevention, but also cardiovascular intervention to minimize the risk of adverse outcomes related to atherosclerotic vascular disease.•The KEEPS trial is an ideal setting to assess the correlation between progression of CAC and changes in volumetric BMD and the effect of early initiation of MHT on that association, as the inclusion criteria for KEEPS was a CAC score ≤ 50 Agatston Units.•Our current study demonstrated that, MHT (o-CEE and t-E2) decreases the bone loss among postmenopausal women with CAC progression and would encourage further research.