Tolga ÇAKMAK, İskender KADİFE, Erkan AYHAN, Turgay IŞIK

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

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.

Keywords:

Menopause, non-dipper hypertension, osteoporosis,

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