Osteoporosis International

, Volume 25, Issue 1, pp 97–103

Association between hypertension and fragility fracture: a longitudinal study

  • S. Yang
  • N. D. Nguyen
  • J. R. Center
  • J. A. Eisman
  • T. V. Nguyen
Original Article

DOI: 10.1007/s00198-013-2457-8

Cite this article as:
Yang, S., Nguyen, N.D., Center, J.R. et al. Osteoporos Int (2014) 25: 97. doi:10.1007/s00198-013-2457-8

Abstract

Summary

Hypertension is an independent risk factor for osteoporosis and osteoporotic fracture in postmenopausal women.

Introduction

Although hypertension has been suggested to be associated with increased fracture risk, it is not clear whether the association is independent of bone mineral density (BMD). The present study sought to examine the interrelationships between hypertension, BMD, and fracture risk.

Methods

The study included 1,032 men and 1,701 women aged 50 years and older who were participants in the Dubbo Osteoporosis Epidemiology Study. BMD at the femoral neck and lumbar spine was measured by dual energy X-ray absorptiometry (GE-LUNAR Corp., Madison, WI, USA). The presence of hypertension was ascertained by direct interview and verification through clinical history. The incidence of fragility fractures was ascertained by X-ray report during the follow-up period (1989–2008). The Cox proportional hazards model was used to assess the association between hypertension and fracture risk.

Results

Women with hypertension had lower BMD at the femoral neck (0.79 versus 0.82 g/cm2, P = 0.02) than those without the disease. After adjusting for BMD and covariates, hypertension was an independent risk factor for fragility fracture [hazard ratio (HR), 1.49; 95 % CI, 1.13–1.96]. In men, hypertension was associated with higher femoral neck BMD (0.94 versus 0.92 g/cm2, P = 0.02), but the association between hypertension and fracture risk did not reach statistical significance.

Conclusion

Hypertension is associated with increased fracture risk in women, and the association is independent of BMD.

Keywords

Bone mineral densityFracture riskHypertensionOsteoporosis

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2013

Authors and Affiliations

  • S. Yang
    • 1
    • 2
  • N. D. Nguyen
    • 1
  • J. R. Center
    • 1
    • 5
  • J. A. Eisman
    • 1
    • 3
    • 4
    • 5
  • T. V. Nguyen
    • 1
    • 2
    • 3
  1. 1.Division of Musculoskeletal DiseasesGarvan Institute of Medical ResearchSydneyAustralia
  2. 2.School of Public Health & Community MedicineUniversity of New South WalesSydneyAustralia
  3. 3.St. Vincent’s Clinical SchoolUniversity of New South WalesSydneyAustralia
  4. 4.School of MedicineThe University of Notre Dame AustraliaFremantleAustralia
  5. 5.Department of EndocrinologySt. Vincent’s HospitalSydneyAustralia