title: Effect of angiotensin II receptor blocker, olmesartan, on turnover of bone metabolism in bedridden elderly hypertensive women with disuse syndrome.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan.
authors.forename: Motokuni
authors.initials: M
authors.lastname: Aoki
authors.affiliation: Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Kawahata
authors.affiliation: Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sotobayashi
authors.affiliation: Hanwa Daini Senboku Hospital, Osaka, Japan.
authors.forename: Hisahiro
authors.initials: H
authors.lastname: Yu
authors.affiliation: Hanwa Daini Senboku Hospital, Osaka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Moriguchi
authors.affiliation: Division of Vascular Medicine and Epigenetics, United Graduate School of Child Development, Osaka University, Osaka, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Nakagami
authors.affiliation: Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Ogihara
authors.affiliation: Department of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, Osaka, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Morishita
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D015519:Bone Density / Q000187:drug effects*; D001862:Bone Resorption; D002121:Calcium Channel Blockers / Q000008:administration & dosage* / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy*; D007093:Imidazoles / Q000008:administration & dosage* / Q000009:adverse effects; D007103:Immobilization; D015994:Incidence; D007564:Japan; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011379:Prognosis; D018570:Risk Assessment; D013777:Tetrazoles / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D057911:Angiotensin Receptor Antagonists; D002121:Calcium Channel Blockers; D007093:Imidazoles; D013777:Tetrazoles; C437965:olmesartan
keywords: angiotensin II receptor blocker; bone metabolism; bone mineral density; disuse syndrome; hypertension