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Title: Beta-blocker use is associated with fragility fractures in postmenopausal women with coronary heart disease
Authors: Sosa, Manuel 
Saavedra Santana, Pedro 
Gómez De Tejada Romero, Mª Jesús 
Mosquera, José
Pérez-Cano, Ramón
Olmos, José Manuel
Muñoz-Torres, Manuel
Amérigo, María José
Moro, María Jesús
Díaz-Curiel, Manuel
Alegre, Javier
Malouf, Jorge
Del Pino, Javier 
Nogués, Xavier
Torrijos, Antonio
Castro, A.
Montoya Garcia, M. J.
Vázquez Gámez, M. A.
Valero, C.
González Maclas, J.
Alonso, G.
Mao, L.
Núñez, J. J.
Pastor Palnas, A.
Garcia Arias, M.
Farrerons Minguella, J.
Diez Pérez, A.
Quintana, E.
Hemández Hemández, D.
UNESCO Clasification: 320501 Cardiología
320108 Ginecología
Keywords: Atherosclerosis
Bone Mineral Density
Coronary Heart Disease
Fracture, et al
Issue Date: 2011
Journal: Aging - Clinical and Experimental Research 
Abstract: Background and aims: An association between cardiovascular disease and osteoporosis is described. A number of drugs often used by patients with coronary heart disease, such as thiazides, statins and beta-blockers, have shown controversial effects on bone. 1) To study the possible association between coronary heart disease (CHD) and bone mass density (BMD), quantitative ultrasound measurements (QUS) and the prevalence of fragility and vertebral fractures. 2) To study the possible influence of a number of drugs, statins, thiazides and beta-blockers, on BMD and fractures. Methods: Case-control study performed on 74 postmenopausal women who had recently suffered from CHD, and 111 age-matched controls. BMD was measured by Dual X-Ray Absorptiometry (DXA) at the lumbar spine and proximal femur. Quantitative Ultrasound (QUS) was also measured at the heel. Vertebral fractures were diagnosed by lateral, thoracic and lumbar X-rays. The occurrence of non-vertebral fractures was determined by examination of medical records. Results: Patients with CHD had higher values of BMI. They had a higher prevalence of arterial hypertension and hyperlipidemia, and consequently higher consumption of beta-blockers and statins, but not of thiazides, and had lower alcohol consumption. Patients with CHD had higher BMD values, measured by DXA at the proximal femur, than controls, but there were no differences in DXA values at the lumbar spine or QUS at the heel between the two groups. The prevalence of all fragility factures was slightly higher in patients with CHD, but not to a significant extent. The prevalence of vertebral fractures was similar in the two groups. In a logistic analysis to identify factors associated with all fractures, beta-blockers were positively associated with fragility fractures, and DXA at the femoral neck was inversely associated with fragility fractures. Conclusions: Postmenopausal women with CHD have higher values of BMD at the proximal femur but, despite this, show a slight but nonsignificant increase in the prevalence of fragility fractures. Beta-blockers are independently associated with fragility fractures, but thiazides and statins are not.
ISSN: 1594-0667
Source: Aging - Clinical and Experimental Research [ISSN 1594-0667], v. 23 (2), p. 112-117, (Abril 2011)
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