Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Anti-Hypertensive Therapy and Bone Mineral Density: Analysis in a Population-Based U.S. Sample.

Kinjo3,  Mitsuyo, Setoguchi1,  Soko, Solomon2,  Daniel Hal

Brigham and Women's Hospital
Brigham and Womens Hospital, Boston, MA
Okinawa Chubu Hospital, Japan

Background:

Several prior studies suggest that beta-blockers and anigiotensin converting enzyme inhibitors (ACE-I) may increase bone mineral density (BMD) in humans. Many studies have examined fracture risks associated with anti-hypertensive treatments. We examined BMD in subjects using beta-blockers, ACE-Is, angiotensin receptor blockers (ARBs), calcium, thiazide diuretics and calcium channel blockers (CCBs), and BMD in a representative U.S. population-based sample from the National Health and Nutrition Examination Survey 1988–1994 (NHANES III) and 1999–2004.

Methods:

We identified adult subjects 20 years and older using beta blockers, ACE-Is, ARBs, thiazide diuretics, or CCBs who underwent dual energy X-ray absorptiometry scanning in NHANES. Femoral neck BMD available in NHANES III and lumbar spine BMD in NHANES1999–2004 were examined. Subjects on beta blockers, ACE-I or thiazide monotherapy were compared to CCB users in adjusted linear regression models that included known demographic, anthropometric, and medical risk factors for osteoporosis.

Results:

The mean age of study subjects was 65 years old. Among subjects with BMD measured, 2,532 used these medications in NHANES III and 1,224 used them in NHANES 1999–2004. In multiple regression analyses (see Table), ACEI use was associated with higher lumbar spine BMD in both women (P = 0.03) and men (P = 0.037). Thiazide use was associated with higher BMD at femoral neck BMD in women, although statistically not significant. Beta-blocker use was only significantly associated at the lumbar spine BMD (P = 0.027) in women. BMD did not differ between ARB and CCB users.

Table 2-1. Adjusted BMD (least square mean) among female subjects in NHANES 1999–2004 and NHANES III

 BBP-valueACEIP-valueThiazideP-valueARBP-valueCCB
NHANES 1999–2004 (Female)151 99 68 41 132
Lumbar spine BMD1.02 (1.00, 1.05)0.0271.03 (1.00, 1.03)0.030.98 (0.91, 1.03)0.51.00 (0.94, 1.06)0.30.95 (0.92, 0.97)
NHANES III (Female)257 195 110 n/a 389
Femoral Neck BMD0.71 (0.70, 0.71)0.20.73 (0.72, 0.74)0.30.74 (0.73, 0.75)0.082  0.72 (0.71, 0.73)
*age, race, bmi, smoking, and estrogen use only for female

Table 2-2. Adjusted BMD (least square mean) among male subjects in NHANES 1999–2004 and NHANES III

 BBP-valueACEIP-valueThiazideP-valueARBP-valueCCB
NHANES 1999–2004 (Male)158 104 48 40 94
Lumbar spine BMD1.03 (1.01, 1.05)0.71.11 (1.09, 1.14)0.0371.08 (1.00, 1.15)0.71.04 (1.00, 1.09)0.61.05 (1.02, 1.07)
NHANES III (Male)211 186 63 n/a 279
Femoral Neck BMD0.82 (0.81, 0.83)0.50.81 (0.80, 0.82)0.60.83 (0.82, 0.85)0.2  0.81 (0.80, 0.82)

Conclusions:

Bone mineral density appears higher in users of ACE-I and thiazides than CCB users among adults, but a causal relationship is not clear.

To cite this abstract, please use the following information:
Kinjo, Mitsuyo, Setoguchi, Soko, Solomon, Daniel Hal; Anti-Hypertensive Therapy and Bone Mineral Density: Analysis in a Population-Based U.S. Sample. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :958
DOI: 10.1002/art.28725

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