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Long-term use of angiotensin-converting enzyme inhibitors protects against bone loss in African-American elderly men

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Abstract

Summary

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.

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Acknowledgements

The authors received writing support from Patricia Fonseca, a freelance medical writer. The authors would like to acknowledge help from Sara Zwart for preparing figures. Susan Rubin, Steve Kritchevsky, Anne Newmen, Suzanne Satterfield, Diane Ives, Evan Tylavsky, and Jane Cauley contributed to data acquisition.

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Authors and Affiliations

  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 Rianon

  2. Department of Orthopaedic Surgery, UTHealth McGovern Medical School, 6431 Fannin #MSB 6.154, Houston, TX, 77030, USA

    Catherine G. Ambrose

  3. UTHealth School of Public Health, 1200 Pressler, Houston, TX, 77030, USA

    Hannah Pervin

  4. Public Health Analyst - NHLBI, IOD, Building 31, Room 5A07A, Bethesda, MD, 20892, USA

    Melissa Garcia

  5. Department of Kinesiology, The Pennsylvania State University, 268J Recreation Building, University Park, PA, 16802, USA

    Scherezade K. Mama

  6. Department of Epidemiology & Biostatistics, UCSF School of Medicine, 550 16th Street, San Francisco, CA, 94158, USA

    Ann V. Schwartz

  7. Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA

    Brendan Lee

  8. Laboratory of Epidemiology & Pop Science Laboratory (LEPS), National Institute on Aging, Gateway Building, Suite 2N300, Bethesda, MD, 20892, USA

    Tamara Harris

Authors
  1. Nahid Rianon
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  2. Catherine G. Ambrose
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  3. Hannah Pervin
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  4. Melissa Garcia
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  5. Scherezade K. Mama
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  6. Ann V. Schwartz
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  7. Brendan Lee
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  8. Tamara Harris
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All authors approved the final version submitted and are accountable for the accuracy and the integrity of the data presented.

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Correspondence to Nahid Rianon.

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Rianon, N., Ambrose, C.G., Pervin, H. et al. Long-term use of angiotensin-converting enzyme inhibitors protects against bone loss in African-American elderly men. Arch Osteoporos 12, 94 (2017). https://doi.org/10.1007/s11657-017-0387-3

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  • DOI: https://doi.org/10.1007/s11657-017-0387-3

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