Association between renin-angiotensin-aldosterone system blockade and future osteoporotic fracture risk in hypertensive population a population-based cohort study in Taiwan

Chang I. Chen, Jong Shiuan Yeh, Nai Wen Tsao, Fen Yen Lin, Chun Ming Shih, Kuang-Hsing Chiang, Yung-Ta Kao, Yu Ann Fang, Li-Hsueh Tsai, Wen Chi Liu, Hironori Nakagami, Ryuichi Morishita, Yi Jie Kuo, Chun Yao Huang

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12 引文 斯高帕斯(Scopus)

摘要

Tissue renin-angiotensin-aldosterone system (RAAS) activation in sites of osteoporosis had been demonstrated in animal studies; however, the possibility of RAAS blockade to prevent future osteoporotic fracture had rarely been verified in clinical studies. We Used the Taiwan Longitudinal Health insurance database 2000 to 2008, the cohort study comprised patients age over 40 with a recorded new diagnosis of hypertension between January 1, 2000 to December 31, 2008, in addition, patients who had diagnosis of osteoporosis before the date of cohort enter were excluded. After the definite diagnosis of hypertension, each patient was followed until osteoporotic fracture happened or the end of 2008. The occurrence of osteoporotic fracture was evaluated in patients who either were or without taking RAAS blockade agents. Cox proportional hazard regressions were used to evaluate the osteoporotic fracture incidence after adjusting for known confounding factors. In total, 57,132 hypertensive patients comprised the study cohort. Our study results showed that the incidence of osteoporosis fracture in the whole cohort was significantly higher in the RAAS blockade non-user group than the user group. This phenomenon was observed in both sex and all age categories. Sensitivity analysis further showed the concordant lower osteoporosis fracture risk in patients with various RAAS blockers usage durations; the risk of osteoporosis fracture was the lowest in those drug use >365 days when compared with the non-user cohort. In conclusion, our study result demonstrated the lower future osteoporotic fracture risk in hypertensive subjects who received long term RAAS blocker treatment. Abbreviations: ACEI = angiotensin converting enzyme inhibitor, ARB = angiotensin II receptor blockers, AT1R = angiotensin II type 1 receptor, BMD = bone mineral density, CI = confidence interval, COPD = chronic obstructive pulmonary disease, HR = hazard ratio, ICD-9 = International Classification of Disease, 9th Revision, MRA = mineralocorticoid receptor antagonist, RAAS = reninangiotensin-aldosterone system, RANKL = receptor activator of NF-κB ligand.

原文英語
文章編號e8331
期刊Medicine (United States)
96
發行號46
DOIs
出版狀態已發佈 - 11月 2017

ASJC Scopus subject areas

  • 一般醫學

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