Effect of Angiotensin II Receptor Blocker, Olmesartan, on Turnover of Bone Metabolism in Bedridden Elderly Hypertensive Women With Disuse Syndrome

Geriatr Gerontol Int. 2015 Aug;15(8):1064-72. doi: 10.1111/ggi.12406. Epub 2014 Nov 3.

Abstract

Aims: Although recent studies suggest that several antihypertensive drugs could reduce the risk of bone fracture, it is still unclear how these drugs act on bone remodeling, especially in elderly women with severe osteoporosis with disuse syndrome. In the present study, we investigated the effects of a calcium channel blocker (CCB) and an angiotensin II receptor blocker (ARB) on bone metabolism in elderly bedridden women with hypertension and disuse syndrome.

Methods: Elderly bedridden women (aged >75 years) receiving antihypertensive therapy treated with CCB were recruited in the present study. The participants were divided into two groups--CCB group and ARB group--and followed up to 12 months.

Results: Markers of bone resorption were markedly increased, suggesting accelerated bone resorption in the participants of the present study. In the follow-up period, the patients treated with a CCB showed a significant decrease in bone mineral density in a time-dependent manner, accompanied by a significant increase in bone resorption markers, whereas treatment with olmesartan inhibited bone loss, associated with attenuation of increased bone resorption markers. Bone mineral density of femoral neck in the CCB group was significantly lower than that in the ARB group at 6 months.

Conclusion: The present study showed inhibitory effects of an ARB on bone resorption in hypertensive patients with accelerated bone resorption, such as elderly bedridden women, and indicated an important role of the renin-angiotensin system in bone metabolism. In elderly hypertensive patients, ARB might be expected to have additional beneficial potential to maintain bone health in bedridden patients.

Keywords: angiotensin II receptor blocker; bone metabolism; bone mineral density; disuse syndrome; hypertension.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Angiotensin Receptor Antagonists / administration & dosage
  • Angiotensin Receptor Antagonists / adverse effects
  • Bone Density / drug effects*
  • Bone Resorption
  • Calcium Channel Blockers / administration & dosage*
  • Calcium Channel Blockers / adverse effects
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Geriatric Assessment
  • Humans
  • Hypertension / diagnosis
  • Hypertension / drug therapy*
  • Imidazoles / administration & dosage*
  • Imidazoles / adverse effects
  • Immobilization*
  • Incidence
  • Japan
  • Osteoporosis / epidemiology
  • Osteoporosis / etiology*
  • Osteoporosis / physiopathology
  • Prognosis
  • Risk Assessment
  • Tetrazoles / administration & dosage*
  • Tetrazoles / adverse effects

Substances

  • Angiotensin Receptor Antagonists
  • Calcium Channel Blockers
  • Imidazoles
  • Tetrazoles
  • olmesartan