抗高血压药与骨质疏松症
Antihypertensive medications and osteoporosis
  
DOI:
中文关键词:  骨质疏松症  高血压  药物  骨折
英文关键词:Osteoporosis  Hypertension  Cardiovascular medications  Fracturexawym@163. Com
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王烨明 * 天津市天津医院骨科天津 300211 
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中文摘要:
      骨质疏松症和高血压有共同的发病高危因素和病理生理机制,多见于老年人群。对于患者个体而言,二者往往同时存在。因此在进行抗高血压治疗的同时,有必要考虑抗高血压药物对骨密度和脆性骨折发生的影响。目前文献证实,除了袢利尿剂对骨量有负性作用外,噻嗪类利尿剂、血管紧张素转化酶抑制剂(ACEI)和血管紧张素 II 受体阻滞剂(ARB)、β 受体阻滞剂和钙离子通道阻滞剂似乎都有一定骨保护作用,可增加骨密度和强度,降低骨质疏松骨折的发生几率。但尚需要双盲随机对照的临床试验和更多基础实验室证据支持骨质疏松症和高血压的相关性及抗高血压药物缓解骨丢失的作用。
英文摘要:
      Osteoporosis and hypertension share common risk factors and pathological mechanism,they occur mostly in the elderly.The two diseases may coexist in a single individual. Therefore,at the time of using antihypertensive drugs,the impact of the drugs in bone mineral density and in fragile bone fractures should be considered. Current evidences show that loop-acting diuretics are harmful to bone. In contrast,thiazide diuretics,β-blockers,and renin-angiotensin-aldosterone system agent are beneficial to bone by increasing bone mineral density and strength,and diseasing the prevalence of osteoporosis. However,more laboratory evidence and double-blinded,randomized clinical experiments are needed to support the correlation between osteoporosis and hypertension and the preventive effect of bone loss by antihypertensive drugs.
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