Nahid Rianon1, Catherine G Ambrose2, Hannah Pervin3, Melissa Garcia4, Scherezade K Mama5, Ann V Schwartz6, Brendan Lee7, Tamara Harris8. 1. Department of Internal Medicine, Division of Geriatric and Palliative Medicine, UTHealth McGovern Medical School, 6431 Fannin #MSB 5.111, Houston, TX, 77030, USA. Nahid.J.Rianon@uth.tmc.edu. 2. Department of Orthopaedic Surgery, UTHealth McGovern Medical School, 6431 Fannin #MSB 6.154, Houston, TX, 77030, USA. 3. UTHealth School of Public Health, 1200 Pressler, Houston, TX, 77030, USA. 4. Public Health Analyst - NHLBI, IOD, Building 31, Room 5A07A, Bethesda, MD, 20892, USA. 5. Department of Kinesiology, The Pennsylvania State University, 268J Recreation Building, University Park, PA, 16802, USA. 6. Department of Epidemiology & Biostatistics, UCSF School of Medicine, 550 16th Street, San Francisco, CA, 94158, USA. 7. Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. 8. Laboratory of Epidemiology & Pop Science Laboratory (LEPS), National Institute on Aging, Gateway Building, Suite 2N300, Bethesda, MD, 20892, USA.
Abstract
Greater bone mineral density was observed after treating hypertension using angiotensin-converting enzyme inhibitor (ACEi). We report decreased rate of bone loss in hypertensive black men using ACEi for 9 years. There may be a gender- and race-specific effect of ACEi in the prevention of age-associated bone loss. PURPOSE: There is evidence of bone mass preservation in patients receiving ACEis, commonly used to treat hypertension. However, limitations of previous studies include being cross-sectional or only including a short-term follow-up of patients using ACEi and including patients with diabetes, which affects bone metabolism. None of the previous studies described effects of ACEi stratified by race. The objective of this study was to investigate differences in changes in bone mineral density (BMD) in older adults who suffer from hypertension and had reported ACEi use during each study visit for at least 9 years during the study, stratified by gender and race. METHODS: We used data from the Dynamics of Health, Aging and Body Composition (HABC) study, which enrolled 3075 community-dwelling older white and black individuals. We compared changes in femoral neck, total hip, and whole-body BMD after either no use of ACEi (n = 580) or long-term use (at least 9 years) of ACEi (n = 239) in HABC participants with hypertension and no known diagnosis of diabetes mellitus. RESULTS: Overall, BMD values significantly decreased for all subgroups over time. In the stratified multivariate analysis, long-term use of ACEi was associated with a reduced rate of decline for all three BMD measures among black men, but no significant effect was observed in the other subgroups. CONCLUSION: Our findings show a gender- and race-specific effect of ACEi in the prevention of age-associated bone loss that warrants further evaluation.
Greater bone mineral density was observed after treating hypertension using angiotensin-converting enzyme inhibitor (ACEi). We report decreased rate of bone loss in hypertensive black men using ACEi for 9 years. There may be a gender- and race-specific effect of ACEi in the prevention of age-associated bone loss. PURPOSE: There is evidence of bone mass preservation in patients receiving ACEis, commonly used to treat hypertension. However, limitations of previous studies include being cross-sectional or only including a short-term follow-up of patients using ACEi and including patients with diabetes, which affects bone metabolism. None of the previous studies described effects of ACEi stratified by race. The objective of this study was to investigate differences in changes in bone mineral density (BMD) in older adults who suffer from hypertension and had reported ACEi use during each study visit for at least 9 years during the study, stratified by gender and race. METHODS: We used data from the Dynamics of Health, Aging and Body Composition (HABC) study, which enrolled 3075 community-dwelling older white and black individuals. We compared changes in femoral neck, total hip, and whole-body BMD after either no use of ACEi (n = 580) or long-term use (at least 9 years) of ACEi (n = 239) in HABCparticipants with hypertension and no known diagnosis of diabetes mellitus. RESULTS: Overall, BMD values significantly decreased for all subgroups over time. In the stratified multivariate analysis, long-term use of ACEi was associated with a reduced rate of decline for all three BMD measures among black men, but no significant effect was observed in the other subgroups. CONCLUSION: Our findings show a gender- and race-specific effect of ACEi in the prevention of age-associated bone loss that warrants further evaluation.
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