Efecto de la hipertensión arterial sobre la masa ósea de mujeres menopáusicas.

Abstract

JUSTIFICATION The most recent research on bone metabolism open the possibility of a relationship between essential hypertension (HTA), osteoporosis (OP) and ACE Inhibitor (ACEI). OBJECTIVES 1, To study if hypertensive postmenopausal women present different bone density than normotensive menopausal women. 2. To verify on bone mass of hypertensive postmenopausal women the consequences of treatment with fosinopril at effectively antihypertensive doses. METHODOLOGY The sample was formed by 104 menopausal women aged between 40 and 70 years. They come from a Primary Care Center of Puerto de Sagunto and from the Menopause Unit of La Fe Hospital in Valencia. Anamnesis, physical exploration, bone mineral density (DEXA) and markers of bone resorption were practiced on these women. In a second phase of cohorts, 27 women normotensive and 15 hypertensive were selected. Hypertensive women were candidates to treatment antihypertensive with ACEI, reliable and with good control of HTA under this treatment. Cohort exposed received treatment with fosinopril oral. All of them received clinical tracking, basal and after 12 months bone density (BD). RESULTS 1ª PHASE: Significant differences between BD of normotensive and hypertensive women were not observed. They were classified with criteria of the WHO, and it was a significant difference (p 0.04) between both groups, emphasizing greater prevalence of OP between women with HTA (14/45 versus 20/48). 2ª PHASE: The basal and final BD of the exposed women to treatment with fosinopril did not present significant differences. The control group presented differences, with inferior final BD to the basal one in neck of femur (p 0.01) and in lumbar column (p 0.002). The basal and final determination of Deoxipiridinolin by inmunoanalysis in urine of cohort exposed were differents, with final number (6.68 nmol creatinine DPD/mM) smaller than the basal one (6.84 nmol creatinine DPD/mM) (p 0.03). CONCLUSIONS 1. Hypertensive menopausal women present greater prevalence of osteoporosis than normotensive women. 2. The treatment of essential hypertension in postmenopausal women with fosinopril at the used doses is associated to the absence of the loss of bone mass related to the age in the group included in this study.