Comparative Evaluation of Enalapril and Losartan in Pharmacological Correction of Experimental Osteoporosis and Fractures of Its Background

Abstract

In the experiment on the white Wistar female rats (222 animals), the osteoprotective effect of enalapril and losartan was studied on experimental models of osteoporosis and osteoporotic fractures. It was revealed that in rats after ovariectomy, the endothelial dysfunction of microcirculation vessels of osteal tissue develops, resulting in occurrence of osteoporosis and delay of consolidation of experimental fractures. Enalapril and losartan prevented the reduction of microcirculation in bone, which was reflected in slowing the thinning of bone trabeculae and in preventing the occurrence of these microfractures, as well as increasing quality of experimental fractures healing.

Morphometric and histologic characterization of alveolar bone from hypertensive patients

“…Under preclinical conditions, losartan also increased bone mass and bone strength, and decreased the percentage of trabecular porosity in osteoporotic conditions comparable to control conditions . The same osteoprotective effect was demonstrated on femoral fractures on osteoporotic rats, where losartan increased microcirculation, and consequently fracture consolidation . Similarly, captopril improved osteopenia and reversed the effect of ovariectomy in rats, with a rise in bone formation .…”

“…23 The same osteoprotective effect was demonstrated on femoral fractures on osteoporotic rats, where losartan increased microcirculation, and consequently fracture consolidation. 34 Similarly, captopril improved osteopenia and reversed the effect of ovariectomy in rats, with a rise in bone formation. 35 Another study showed that treatment with captopril improved the trabecular bone area of lumbar vertebrae and enhanced the bone mechanical properties by increasing break stress and elastic modulus in ovariectomized rats.…”

Risk of Osteoporotic Fractures With Angiotensin II Receptor Blockers Versus Angiotensin-Converting Enzyme Inhibitors in Hypertensive Community-Dwelling Elderly

“…(10) Another study comparing the effect of an ARB (losartan) to an ACE inhibitor (enalapril) on bone in ovariectomized rats found that the ARB had a greater osteoprotective effect than the ACE inhibitor. (4) Other studies have indicated that ARBs did not accelerate bone loss in ovariectomized normotensive and hypertensive rats. (11,12) There are fewer studies in humans examining the effect of ARBs versus ACE inhibitors on bone.…”

“…Using ovariectomized rats as a model of estrogen deficiency, treatment with an ARB (losartan) in hypertensive rats improved bone density and increased both bone density and bone quality in normotensive rats . Another study comparing the effect of an ARB (losartan) to an ACE inhibitor (enalapril) on bone in ovariectomized rats found that the ARB had a greater osteoprotective effect than the ACE inhibitor . Other studies have indicated that ARBs did not accelerate bone loss in ovariectomized normotensive and hypertensive rats …”

“…Both in vivo and observational studies have provided conflicting evidence regarding the effect of ACE inhibitors on bone, (3)(4)(5)(6)(7) whereas studies involving ARBs suggest a somewhat osteoprotective effect. (4,5,(8)(9)(10)(11)(12) Given the widespread use and exchangeability of these antihypertensive medications in the elderly for the treatment of hypertension, we conducted a study to examine the risk of osteoporosis-related fractures in community-dwelling hypertensive elderly treated with ARBs relative to ACE inhibitors.…”