Association between hypertension and fragility fracture: a longitudinal study
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Hypertension is an independent risk factor for osteoporosis and osteoporotic fracture in postmenopausal women.
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.
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.
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.
Hypertension is associated with increased fracture risk in women, and the association is independent of BMD.
KeywordsBone mineral density Fracture risk Hypertension Osteoporosis
The work was not supported by any funding body. The Dubbo Osteoporosis Epidemiology Study was supported in part by the National Health and Medical Research Council (NHMRC) grant 276413. This study also received support from the MBF Living Well Foundation; the Ernst Heine Foundation; and untied grants from Amgen, Merck Sharp & Dohme, Sanofi-Aventis, Servier, and Novartis. We thank Janet Watters, Sue Boyd, Carol Gilbert, Angie Ferguson, Di Conn, Donna Reeves, Shaye Field, Glenys Hubbard, and Sharon Erockson of Garvan Institute of Medical Research in Dubbo for data collection.
Conflicts of interest
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