Association of Hypertension and Bone Mineral Density in an Elderly African American Female Population

Javed, Fawad; Khan, Sobia; Ayers, Eric; Aziz, Emad F.; Akram, Muhammad Shoaib; Nadkarni, Girish N.; Sabharwal, Manpreet Singh; Ahmad, Zurish; Benjo, Alexandre; Herzog, Eyal

doi:10.1016/s0027-9684(15)30140-1

Cited by 25 publications

(24 citation statements)

References 31 publications

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“…Hypertension is a systemic disorder characterized by impaired bone turnover culminating in decreased bone mineral density, and consequently bone fractures . Hypertension also affects alveolar bone quality in a rat model suggesting a possible impact on implant stability in the early phase of osseointegration.…”

Section: Discussionmentioning

confidence: 99%

Morphometric and histologic characterization of alveolar bone from hypertensive patients

Fábris

Mulinari‐Santos

Hassumi

et al. 2017

Clin Implant Dent Rel Res

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Section: Discussionmentioning

confidence: 99%

Morphometric and histologic characterization of alveolar bone from hypertensive patients

Fábris

Mulinari‐Santos

Hassumi

et al. 2017

Clin Implant Dent Rel Res

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“…This inconsistency is likely due to differences in study design, population, and dose and duration of drug administered. For example, a cross-sectional study in African-American women found no significant difference in BMD between individuals who were taking thiazides and those who were not [18]. Overall, however, the evidence supports a positive albeit small effect of thiazides in terms of increasing BMD or preventing decreases in BMD.…”

Section: Thiazides and Bmdmentioning

confidence: 97%

“…Thiazides decrease blood pressure by reducing sodium reabsorption in the distal convoluted tubules of the kidney. Multiple studies have identified an association between thiazide use and increased BMD ( Table 2; [16][17][18][19][20]). The mechanism that most likely accounts for this effect is a thiazideinduced reduction in urinary calcium excretion [21].…”

Section: Thiazides and Bmdmentioning

confidence: 99%

“…Evidence from most but not all observational studies and RCTs has found a positive effect of thiazides on BMD ( Table 2; [16][17][18][19][20] Clinic Rev Bone Miner Metab (9.6 % increase in the lumbar spine and 5.4 % increase in the total body, both p \ 0.01) compared to controls [17]. The increased BMD from thiazide use was found to be independent of PTH levels [17], suggesting that there were other mechanisms of action responsible for the differences in BMD.…”

Section: Thiazides and Bmdmentioning

confidence: 99%

“…In addition, both crosssectional studies and RCTs suggest that the impact of thiazides on BMD is greater among women than among men, likely because women have greater bone loss with the loss of estrogen around menopause [16,20]. Although most studies have found a positive effect of thiazides on BMD, some have not [18]. This inconsistency is likely due to differences in study design, population, and dose and duration of drug administered.…”

Section: Thiazides and Bmdmentioning

confidence: 99%

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Hypertension, Antihypertensive Drugs, and Bone Mineral Density

Hwang

Leu

Butt

2015

Clinic Rev Bone Miner Metab

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Hypertension and osteoporosis are often present concomitantly in older adults. This narrative review summarizes current knowledge on the effects of hypertension on bone mineral density (BMD) and the effects of major classes of antihypertensive medications on BMD. The relationship between hypertension and BMD has been studied extensively, but remains highly controversial. Commonly prescribed antihypertensive medications, such as thiazides, beta-adrenergic blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and calcium channel blockers, have mechanisms of action through which they could potentially affect bone metabolism and BMD. The evidence supports a small positive effect of thiazides in terms of increasing BMD or preventing decrease in BMD. Studies of the effect of betaadrenergic blockers and angiotensin-converting enzyme inhibitors on BMD have shown conflicting results. Very few studies have examined the effect of angiotensin II receptor blockers on BMD, and these studies are inconclusive. Studies of calcium channel blockers have found conflicting effects on BMD. Overall, definitive conclusions cannot be reached on the effect of antihypertensive drugs on BMD other than for thiazide diuretics.

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Rates of and Risk Factors for Trabecular and Cortical BMD Loss in Middle-Aged and Elderly African-Ancestry Men

Sheu

Bunker

Jonnalagadda

et al. 2014

Journal of Bone and Mineral Research

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Low trabecular (Tb) and cortical (Ct) volumetric BMD (vBMD) are related to increased fracture risk, but little is known about the patterns and correlates of Tb and Ct vBMD loss with aging. We examined the rates of change in total, Tb.vBMD and Ct.vBMD at the radius and tibia, and identified factors associated with vBMD loss among 1,569 men of African descent aged 40 years and older. Quantitative computed tomography was used to measure vBMD 6 years apart. The annualized rate of loss in Tb.vBMD was significant at the radius (−0.047%/yr, p=0.016) but not tibia. At the radius, a significant loss of Tb.vBMD was observed in men aged 40-49 that appeared to be attenuated and not statistically significant among older age men. In contrast, the decline in Ct.vBMD was similar at both skeletal sites (−0.254 to −0.264%/yr, p<0.0001) and was consistent across all age groups. Positive associations were found for vBMD changes with body weight (all but radius Ct.vBMD) and diabetes (Ct.vBMD only), while negative associations were found with hypertension (all but radius Tb.vBMD), smoking (Ct.vBMD only), and androgen deprivation therapy (cortical vBMD only). Trabecular and cortical vBMD loss appears to follow different patterns among middle- and older-aged men of African ancestry. Factors associated with the decline in vBMD also varied by compartment and anatomical site. Additional studies are needed to better understand the physiological mechanisms underlying early BMD loss among African ancestry men.

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Association of Hypertension and Bone Mineral Density in an Elderly African American Female Population

Cited by 25 publications

References 31 publications

Morphometric and histologic characterization of alveolar bone from hypertensive patients

Morphometric and histologic characterization of alveolar bone from hypertensive patients

Hypertension, Antihypertensive Drugs, and Bone Mineral Density

Rates of and Risk Factors for Trabecular and Cortical BMD Loss in Middle-Aged and Elderly African-Ancestry Men

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