Primary Hypertension May Not Affect Prognosis of Postmenopausal Osteoporosis

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The presence of primary hypertension does not appear to have an effect on the prognosis of postmenopausal osteoporosis.

The presence of primary hypertension does not appear to have an effect on the prognosis of postmenopausal osteoporosis, according to the results of a 5-year follow-up retrospective study published in High Blood Pressure & Cardiovascular Prevention.

The investigators sought to explore the effect of primary hypertension on the prognosis of treatment among patients with postmenopausal osteoporosis. A total of 89 individuals who were followed between 2010 and 2015, having met World Health Organization criteria, were evaluated. Patient data were assessed retrospectively for biochemical and bone mineral density (BMD) screening tests. Overall, 45 patients diagnosed with postmenopausal osteoporosis with lumbar spine or femur neck BMD screening, no history of postmenopausal osteoporosis treatment, and who had comorbid primary hypertension and were being treated with a vasodilator antihypertensive agent for ≥1 year, were enrolled in the study. The control group comprised 44 individuals with postmenopausal osteoporosis who were age matched with the cases, had no comorbidity (including primary hypertension), and had not received any postmenopausal osteoporosis treatment.

Demographic features, including age, weight, height, body mass index, occupation, level of education, number of pregnancies, age of menarche and menopause, smoking status, alcohol consumption, clothing style, daily intake of calcium, daily level of physical activity, personal history of fragility fracture in mother, and duration of primary hypertension, were all recorded. Biochemical parameters were documented as well. All participants were treated with bisphosphonates, calcium, and vitamin D. All parameters were evaluated at the end of the first and fifth years of the study.

Prior to treatment for postmenopausal osteoporosis, demographic and disease characteristics did not differ significantly between the groups (P >.05). Compared with baseline; however, significant improvements in lumbar and femur neck T scores were reported in patients with postmenopausal osteoporosis and in patients with postmenopausal osteoporosis and hypertension following 1 year and 5 years of treatment (P <.05 in both groups). Moreover, lumbar and femur neck T score variations at baseline, at the first year, and at the fifth year of treatment did not differ significantly in patients with postmenopausal osteoporosis with or without hypertension (P <.05 for both).

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The investigators concluded that no significant relationship was observed between those with or without hypertension who had postmenopausal hypertension prior to treatment with bisphosphonates, calcium, and vitamin D. Some antihypertensive therapies, such as angiotensin-converting enzyme inhibitors, may positively affect bone metabolism. Further, certain risk factors for postmenopausal osteoporosis, including ethnicity, may affect the BMD scores of patients with primary hypertension and comorbid postmenopausal osteoporosis. Additional multicenter studies with larger patient groups are warranted to identify the real effect of primary hypertension and treatment regimens on bone metabolism.

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Yilmaz V, Umay E, Gundogdu I, Cakcı FA.  Effect of primary hypertension on treatment outcomes of patients with postmenopausal osteoporosis: a 5 year follow up retrospective study [published online November 22, 2018]. High Blood Press Cardiovasc Prev. doi: 10.1007/s40292-018-0291-y