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The relationship between osteoporosis and non-dipper hypertension in postmenopausal women

Year 2023, Volume: 6 Issue: 5, 898 - 904, 28.09.2023
https://doi.org/10.32322/jhsm.1302874

Abstract

Aims: Previous studies have shown association between hypertension and osteoporosis, however has not been evaluated alterations of circadian blood pressure patterns. The present study investigated the effects of osteoporosison the circadian blood pressure assessed by ambulatory blood pressure monitoring.
Methods: 68 patients (mean age: 61.3±8.7 years, 34 dipper and 34 non-dipper patients) with postmenopausal hypertension (HT) were prospectively enrolled in this study. Ambulatory blood pressure monitoring was performed on all patients. We measured bone mineral density (BMD) and T-score by dual X- ray absorptiometry at the lumbar spine. The receiver operating characteristics (ROC) curve was used to demonstrate the sensitivity and specificity of lumbar spine BMD, optimal cut - off value for predicting non-dipper hypertension (NDHT).
Results: T-score and BMD in non-dipper patients were lower than the dipper patients. There was a significant correlation between the rate of fall in night of mean blood pressure and both lumbar spine T-score and lumbar spine BMD (r= 0.330 and P =0.006 vs r=0.322 and P =0.007, respectively). A lumbar spine BMD <0.944 g/cm2 measured by DXA had a 64.7% sensitivity and 64.7% specificity in predicting non-dipper hypertension at ROC curve analysis.
Conclusion: Low lumbar spine BMD is an independent and strong predictor of non-dipper hypertension. Osteoporosis may be an indicator of cardiovascular risk. Therefore, osteoporotic patients should be treated more aggressively.

References

  • Kaya MG, Yarlioglues M, Gunebakmaz O, et al. Platelet activation and inflammatory response in patients with non-dipper hypertension. Atherosclerosis. 2010;20(1)9:278-82.
  • Mancia G, Fagard R, Narkiewicz K, et. al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159-219.
  • Routledge FS, McFetridge-Durdle JA, Dean CR. Stress, menopausal status and nocturnal blood pressure dipping patterns among hypertensive women. Can J Cardiol. 2009;25(6):e157-63.
  • Pusuroglu H, Cakmak HA, Erturk M, et al. Assessment of the relation between mean platelet volume, non-dipping blood pressure pattern and left ventricular mass index in sustained hypertension. Med Sci Monit. 2014;20:2020-2026.
  • Frost ML, Grella R, Millasseau SC, et al. Relationship of calcification of atherosclerotic plaque and arterial stiffness to bone mineraldensity and osteoprotegerin in postmenopausal women referred for osteoporosis screening. Calcif Tissue Int. 2008;83(2):112-120.
  • Cappuccio FP, Meilahn E, Zmuda JM, Cauley JA. High blood pressure and bone-mineral loss in elderly white women: a prospective study. Study of Osteoporotic Fractures Research Group. Lancet. 1999;354(9183):971-975.
  • White HD, Ahmad AM, Durham BH, et al. PTH circadian rhythm and PTH target-organ sensitivity is altered in patients with adult growth hormone deficiency with low BMD. J Bone Miner Res. 2007;22(11):1798-1807.
  • Asaba Y, Ito M, Fumoto T, et al. Activation of renin- angiotensin system induces osteoporosis independently of hypertension. J Bone Miner Res. 2009;24(2):241-250.
  • Pérez-Castrillón JL, Justo I, Sanz A, et al. Ghrelin and bone mass in postmenopausal hypertensive women. Ann Nutr Metab. 2007;51(3):223-227.
  • Woo J, Kwok T, Leung J, Tang N. Dietary intake, blood pressure and osteoporosis. J Hum Hypertens. 2009;23(7):451-455.
  • Turfaner N, Karter Y, Curgunlu A, Ayan F, Mihmanli I, Sipahioglu F. Blunted nocturnal fall of blood pressure in isolated clinical hypertension. Swiss Med Wkly. 2009;139(17-18):251-255.
  • Aydin M, Ozeren A, Bilge M, Dursun A, Cam F, Elbey MA. Effects of dipper and non- dipper status of essential hypertension on left atrial mechanical functions. Int J Cardiol. 2004;96(3):419-424.
  • Sforza E, Thomas T, Barthélémy JC, Collet P, Roche F. Obstructive sleep apnea is associated with preserved bone mineral density in healthy elderly subjects. Sleep. 2013;36(10):1509-1515.
  • Dahlén EM, Bjarnegård N, Länne T, Nystrom FH, Ostgren CJ. Sagittal abdominal diameter is a more independent measure compared with waist circumference to predict arterial stiffness in subjects with type 2 diabetes-a prospective observational cohort study. Cardiovasc Diabetol. 2013;12:55.
  • Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two- Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989;2(5):358-367.
  • Iacobellis G, Ribaudo MC, Assael F, et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab. 2003;88(11):5163-5168.
  • Kassi E, Pervanidou P, Kaltsas G, Chrousos G. Metabolic Syndrome: Definitions and Controversies. BMC Med. 2011;9:48
  • Alberti KGMM, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; And International Association for the Study of Obesity. Circulation. 2009;120(16):1640–1645.
  • Henriksen DB, Alexandersen P, Hartmann B, et al.Disassociation of bone resorption and formation byGLP-2: a 14-day study in healthy postmenopausal women. Bone. 2007;40:723-729.
  • Fraser WD, Ahmad AM, Vora JP.The physiology of the circadian rhythm of parathyroid hormone and its potential as atreatment for osteoporosis. Curr Opin Nephrol Hypertens. 2004;13(4):437-444.
  • Brown JM, Williams JS, Luther JM, et al. Human interventions to characterize novel relationships between the renin-angiotensin-aldosterone system and parathyroid hormone. Hypertension. 2014;63(2):273-280.
  • Liu J, Huang F, He HW. Melatonin effects on hard tissues: bone and tooth. Int J Mol Sci. 2013;14(5):10063-10074.
  • Tosun A, Doğru MT, Aydın G, et al. Does autonomic dysfunction exist inpostmenopausal osteoporosis? Am J Phys Med Rehabil. 2011;90(12):1012-1019.
  • Gunebakmaz O, Kaya MG, Duran M, Akpek M, Elcik D, Eryol NK. Red blood cell distribution width in 'non-dippers' versus 'dippers'. Cardiology. 2012;123(3):154-159.
  • Afsar B, Elsurer R, Ozdemir FN, Sezer S. Uric acid and nocturnal nondipping in hypertensive patients with normal renal function. J Nephrol. 2008;21(3):406-411.
  • Ishii S, Miyao M, Mizuno Y, Tanaka-Ishikawa M, Akishita M, Ouchi Y. Association between serum uric acid and lumbar spine bone mineral density in peri- and postmenopausal Japanese women. Osteoporos Int. 2014;25(3):1099-1105.
  • Mariani S, Fiore D, Barbaro G, et al. Association of epicardial fat thickness with the severity of obstructive sleep apnea in obese patients. Int J Cardiol. 2013;167(5):2244-2249.
Year 2023, Volume: 6 Issue: 5, 898 - 904, 28.09.2023
https://doi.org/10.32322/jhsm.1302874

Abstract

References

  • Kaya MG, Yarlioglues M, Gunebakmaz O, et al. Platelet activation and inflammatory response in patients with non-dipper hypertension. Atherosclerosis. 2010;20(1)9:278-82.
  • Mancia G, Fagard R, Narkiewicz K, et. al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2013;34(28):2159-219.
  • Routledge FS, McFetridge-Durdle JA, Dean CR. Stress, menopausal status and nocturnal blood pressure dipping patterns among hypertensive women. Can J Cardiol. 2009;25(6):e157-63.
  • Pusuroglu H, Cakmak HA, Erturk M, et al. Assessment of the relation between mean platelet volume, non-dipping blood pressure pattern and left ventricular mass index in sustained hypertension. Med Sci Monit. 2014;20:2020-2026.
  • Frost ML, Grella R, Millasseau SC, et al. Relationship of calcification of atherosclerotic plaque and arterial stiffness to bone mineraldensity and osteoprotegerin in postmenopausal women referred for osteoporosis screening. Calcif Tissue Int. 2008;83(2):112-120.
  • Cappuccio FP, Meilahn E, Zmuda JM, Cauley JA. High blood pressure and bone-mineral loss in elderly white women: a prospective study. Study of Osteoporotic Fractures Research Group. Lancet. 1999;354(9183):971-975.
  • White HD, Ahmad AM, Durham BH, et al. PTH circadian rhythm and PTH target-organ sensitivity is altered in patients with adult growth hormone deficiency with low BMD. J Bone Miner Res. 2007;22(11):1798-1807.
  • Asaba Y, Ito M, Fumoto T, et al. Activation of renin- angiotensin system induces osteoporosis independently of hypertension. J Bone Miner Res. 2009;24(2):241-250.
  • Pérez-Castrillón JL, Justo I, Sanz A, et al. Ghrelin and bone mass in postmenopausal hypertensive women. Ann Nutr Metab. 2007;51(3):223-227.
  • Woo J, Kwok T, Leung J, Tang N. Dietary intake, blood pressure and osteoporosis. J Hum Hypertens. 2009;23(7):451-455.
  • Turfaner N, Karter Y, Curgunlu A, Ayan F, Mihmanli I, Sipahioglu F. Blunted nocturnal fall of blood pressure in isolated clinical hypertension. Swiss Med Wkly. 2009;139(17-18):251-255.
  • Aydin M, Ozeren A, Bilge M, Dursun A, Cam F, Elbey MA. Effects of dipper and non- dipper status of essential hypertension on left atrial mechanical functions. Int J Cardiol. 2004;96(3):419-424.
  • Sforza E, Thomas T, Barthélémy JC, Collet P, Roche F. Obstructive sleep apnea is associated with preserved bone mineral density in healthy elderly subjects. Sleep. 2013;36(10):1509-1515.
  • Dahlén EM, Bjarnegård N, Länne T, Nystrom FH, Ostgren CJ. Sagittal abdominal diameter is a more independent measure compared with waist circumference to predict arterial stiffness in subjects with type 2 diabetes-a prospective observational cohort study. Cardiovasc Diabetol. 2013;12:55.
  • Schiller NB, Shah PM, Crawford M, et al. Recommendations for quantitation of the left ventricle by two-dimensional echocardiography. American Society of Echocardiography Committee on Standards, Subcommittee on Quantitation of Two- Dimensional Echocardiograms. J Am Soc Echocardiogr. 1989;2(5):358-367.
  • Iacobellis G, Ribaudo MC, Assael F, et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab. 2003;88(11):5163-5168.
  • Kassi E, Pervanidou P, Kaltsas G, Chrousos G. Metabolic Syndrome: Definitions and Controversies. BMC Med. 2011;9:48
  • Alberti KGMM, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; And International Association for the Study of Obesity. Circulation. 2009;120(16):1640–1645.
  • Henriksen DB, Alexandersen P, Hartmann B, et al.Disassociation of bone resorption and formation byGLP-2: a 14-day study in healthy postmenopausal women. Bone. 2007;40:723-729.
  • Fraser WD, Ahmad AM, Vora JP.The physiology of the circadian rhythm of parathyroid hormone and its potential as atreatment for osteoporosis. Curr Opin Nephrol Hypertens. 2004;13(4):437-444.
  • Brown JM, Williams JS, Luther JM, et al. Human interventions to characterize novel relationships between the renin-angiotensin-aldosterone system and parathyroid hormone. Hypertension. 2014;63(2):273-280.
  • Liu J, Huang F, He HW. Melatonin effects on hard tissues: bone and tooth. Int J Mol Sci. 2013;14(5):10063-10074.
  • Tosun A, Doğru MT, Aydın G, et al. Does autonomic dysfunction exist inpostmenopausal osteoporosis? Am J Phys Med Rehabil. 2011;90(12):1012-1019.
  • Gunebakmaz O, Kaya MG, Duran M, Akpek M, Elcik D, Eryol NK. Red blood cell distribution width in 'non-dippers' versus 'dippers'. Cardiology. 2012;123(3):154-159.
  • Afsar B, Elsurer R, Ozdemir FN, Sezer S. Uric acid and nocturnal nondipping in hypertensive patients with normal renal function. J Nephrol. 2008;21(3):406-411.
  • Ishii S, Miyao M, Mizuno Y, Tanaka-Ishikawa M, Akishita M, Ouchi Y. Association between serum uric acid and lumbar spine bone mineral density in peri- and postmenopausal Japanese women. Osteoporos Int. 2014;25(3):1099-1105.
  • Mariani S, Fiore D, Barbaro G, et al. Association of epicardial fat thickness with the severity of obstructive sleep apnea in obese patients. Int J Cardiol. 2013;167(5):2244-2249.
There are 27 citations in total.

Details

Primary Language English
Subjects Cardiology, Health Care Administration
Journal Section Original Article
Authors

Tolga Çakmak 0000-0002-4981-5521

İskender Kadife 0000-0002-0216-2359

Erkan Ayhan 0000-0002-9663-6235

Turgay Işık 0000-0002-7090-8765

Early Pub Date September 26, 2023
Publication Date September 28, 2023
Published in Issue Year 2023 Volume: 6 Issue: 5

Cite

AMA Çakmak T, Kadife İ, Ayhan E, Işık T. The relationship between osteoporosis and non-dipper hypertension in postmenopausal women. J Health Sci Med / JHSM. September 2023;6(5):898-904. doi:10.32322/jhsm.1302874

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