title: Association of history of fracture with prehypertension and hypertension: a retrospective case-control study.
abstract: BACKGROUND
  Hypertension is one of the most common encountered medical comorbidities after hip fracture. Whether fracture is a potential risk factor for hypertension remains poorly understood. The aim of our study was to examine the risk of prehypertension and hypertension in the participants with and without a history of fracture.
  
  
  METHODS
  We conducted a retrospective case-control study of 3,515 men and women aged between 20 and 85 years old from the National Health and Nutrition Examination Survey 2005-2006. History of fracture was collected via structured questionnaire. Multiple blood pressure readings (up to 4 times) were performed at interview, and an average of blood pressure readings were used to define prehypertension and hypertension.
  
  
  RESULTS
  Among 3,515 participants, 30% (n = 1074), 1.4% (n = 48) and 10% (n = 347) of them had a history of any, hip and wrist fracture, respectively. The positive association between history of any, hip and wrist fracture and prehypertension was similar to the association between history of any, hip and wrist fracture and hypertension in both unadjusted and adjusted model. In the unadjusted model, history of any, hip and wrist fracture was each associated with increased overall risk of prehypertension and hypertension (odds ratio [OR] = 1.61, 95% confidence interval [CI] = 1.38-1.89 for any fracture; OR = 3.57, 95% CI = 1.60-8.00 for hip fracture; and OR = 1.82, 95% CI = 1.41-2.36 for wrist fracture). However, in multivariable adjusted model, only the positive association between history of wrist fracture and overall risk of prehypertension and hypertension remained significant (OR = 1.48, 95% CI = 1.10-1.99).
  
  
  CONCLUSIONS
  There was no overall independent association between history of fracture, and risk of prehypertension and hypertension. Although history of fracture overall may not directly cause hypertension, people with a history of wrist fracture can be potentially benefitted from hypertension control at the early stage.
authors.affiliation: Department of Environmental Health, Division of Epidemiology and Biostatistics, University of Cincinnati Medical Center, 3223, Eden Ave, Cincinnati, Ohio, USA. yangsm@ucmail.uc.edu.
authors.forename: Shuman
authors.initials: S
authors.lastname: Yang
authors.affiliation: Department of Environmental Health, Division of Epidemiology and Biostatistics, University of Cincinnati Medical Center, 3223, Eden Ave, Cincinnati, Ohio, USA. chenai@ucmail.uc.edu.
authors.forename: Aimin
authors.initials: A
authors.lastname: Chen
authors.affiliation: Department of Environmental Health, Division of Epidemiology and Biostatistics, University of Cincinnati Medical Center, 3223, Eden Ave, Cincinnati, Ohio, USA. wutg@ucmail.uc.edu.
authors.forename: Tianying
authors.initials: T
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys / Q000379:methods; D058246:Prehypertension / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014954:Wrist Injuries / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult