Numerous phosphocalcium alterations associated with bone mineral density in hypertension have been described, but very few studies assess them. This study assesses bone mass in hypertensive postmenopausal women and the hypertension influence determining both calcium homeostasis and bone turnover markers. Blood and urine samples were analysed for calcium metabolism-related parameters. Densitometry studies were conducted in the lumbar spine (L2-L4). Hypertensive osteoporotic womenFselected from 82 women, with 22% osteoporosis prevalence, similar to the rate for the same age in the Spanish populationFhad significantly higher levels of body mass index (29 7 4 vs 26 7 4, P ¼ 0.019), calciuria (293 7 146 vs 210 7 116 mg/ 24 h, P ¼ 0.023) and calcium/creatinine ratio (0.33 7 0.2 vs 0.22 7 0.1 P ¼ 0.003) vs hypertensive nonosteoporotic women. No relation was found between systolic and diastolic blood pressure with bone mass. However, there was a negative osteocalcin correlation (r ¼ À0.386, P ¼ 0.0001, and r ¼ À0.242, P ¼ 0.033). Calciuria is associated with bone mass decrease in hypertensive women, and there is no relation between bone mass and blood pressure.

The financial and social cost of hypertension and osteoporosis, clinically silent diseases, are determined by the consequences, such as a vascular disease and fractures. The relationship between these illnesses has not been clearly established, although many alterations in extracellular metabolism of calcium, which could determine the level of bone mineral density (BMD) in these patients, have been associated to hypertension. Despite these alterations, the lack of studies relating these two important diseases is surprising, and hypertension is not identified as a risk factor for osteoporosis.Interestingly, there is a lack of information of the long-term effects of antihypertensive treatment on bone mineral density, although 50 % of the hypertensive population is made up of postmenopausal women. Most studies analyzed the effects of thiazides and, to a lesser degree, the effects of calcium antagonist.The purpose of this review is evaluate the effect of the antihypertensive therapeutic group (diuretics, β-blockers, calcium antagonists, angiotensin converting enzyme) on the bone mineral density (BMD) and osteoporotic fracture.

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The ACE inhibitors in combination with the presence of the DD genotype decrease the level of 1.25-(OH)2 D. There was no difference between enalapril and quinapril treated groups.

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