Clinical Analysis Of Osteoporosis In Elderly Patients With Hypertension

Objective: To observe the prevalence of osteoporosis in elderly patients with hypertension. And investigate the factors which influence the osteoporosis in the elderly patients with hypertension.Methods: According to the inclusion and exclusion criteria, aged≥60 years 380 cases(185 male and 195 female) of elderly patients with hypertension, from January 2013 to June 2014 in our department, were recruited in this study. All patients were tested for bone mineral density, and according to the bone mineral density, the data were divided into Bone mass normal group, the bone loss and osteoporosis group. The general clinical data and the main risk factors were compared in different genders. At the same time, the data were used for statistical analysis.Results:(1) Compared with the osteoporosis group, the BMI, pre-albumin, uric acid and 25-(OH)D3 in normal bone mass and reduced bone mass group were increased while HDL-C and Hcy were lower, the difference was statistically significant(P <0.05); Compared with reduced bone mass group, uric acid and 25-(OH)D3 in normal bone mass group were increased while Hcy was lower, the difference was statistically significant(P<0.05).(2) The difference of three groups of patients using drugs of CCB was statistically significant(P<0.05), Osteoporosis group of CCB drug usage is lower than normal bone mass and reduced bone mass group.(3) The comparison of first to fourth lumbar BMD in different gender, women BMD is lower than men, the difference was statistically significant(P <0.01). Men normal bone mass accounted for 55.05%, bone loss accounted for 31.89%, OP accounted for 14.05%, women normal bone mass accounted for 15.38%, accounting for 30.77% reduction in bone mass, OP accounting for 53.84%. The detection rate of OP in female was higher than that in male. In 60-69 age group, the 70-79 age group and ≥80 age group, the difference of detection rate of osteoporosis was statistically significant(χ2=9.62, P=0.047). The detection rate of OP increased with age.(4) The difference of SBP variability, DBP variability and dynamic pulse pressure were statistically significant(P<0.05), Compared with osteoporosis group, SBP variability, DBP variability and dynamic pulse pressure value in normal bone mass and reduced bone mass group were reduced.(5) Logistic regression factors in elderly hypertensive patients with osteoporosis showed that BMI, 25-(OH) D3, and prealbumin is a protective factor, while female, Hcy and 24 h DBPV is a risk factor for osteoporosis(P<0.05).(6)In male hypertensive elderly patients, the difference of BMI, Hcy,25-(OH)D3, smoking and pre-albumin in three groups of age were statistically significant(P<0.05). Compared with normal bone mass group, the age, Hcy and rate of smoking in reduced bone mass and osteoporosis group were increased while BMI, 25-(OH)D3 and pre-albumin were decreased.(7) In elderly female patients with hypertension, the difference of age, BMI, menopause, Hcy, 25-(OH)D3, TG, pre-albumin and uric acid in three groups was statistically significant(P<0.05). Compared with normal bone mass group, the age, menopause and Hcy in reduced bone mass and osteoporosis group were increased while BMI, 25-(OH)D3, TG, pre-albumin and uric acid were reduced.Conclusions:(1) Elderly hypertensive patients, age, Hcy may be the risk factors of OP; BMI, prealbumin, 25-(OH) D3, UA may be protective factors.(2) In elderly hypertensive patients BPV is larger, the greater the risk of the occurrence of OP.(3) In elderly hypertensive patients, the use of CCB class of anti-hypertensive drugs may be a protective factor in OP.(4) Women prone to OP than men, related to the duration of menopause and TG.