Investigating the effect of history of fractures and hypertension on the risk of all-cause death from osteoporosis: A retrospective cohort study

Abstract

To assess the coexistence effect between history of fractures and hypertension on the all-cause death risk of osteoporosis. In this retrospective cohort study, some characteristics of osteoporosis patients aged ≥ 20 years were extracted from the National Health and Nutrition Examination Survey (NHANES) database (2005–2010, 2013–2014), such as age, gender, smoking, drinking, the history of diabetes, cardiovascular and cerebrovascular diseases, fractures and hypertension. The outcome of this study was defined as all-cause death of osteoporosis. These patients were followed up until 2015 with an average follow-up time of 62.00 ± 34.79 months. Univariate and multivariate logistic regression was utilized to evaluate the association of history of fractures and hypertension on all-cause death risk of osteoporosis, respectively. The death risk factors were presented by using relative risk (RR) and 95% confidence interval (CI). The attributable proportion (AP) to explore the interaction between history of fractures and hypertension on the all-cause death risk of osteoporosis. Of the total 801 osteoporosis patients, 227 died. After adjusting age, gender, marital status, education background, annual household income, diabetes, the prior use of prednisone or cortisone medication, cardiovascular and cerebrovascular diseases, the history of fractures (RR = 1.502, 95% CI: 1.035–2.180), spine fracture (RR = 2.944, 95% CI: 1.244–6.967), hip fracture (RR = 2.033, 95% CI: 1.066–3.875) was significantly associated with the increased death risk of osteoporosis. However, there was no significant difference between hypertension and the all-cause death risk of osteoporosis ( P > .05). Additionally, there was a significant interaction between the history of fractures and hypertension on the all-cause death risk of osteoporosis, and the interaction was an enhancement effect (AP = 0.456, 95% CI: 0.005–0.906). The co-existence of the history of fractures and hypertension could increase the all-cause death risk of osteoporosis, which indicated that osteoporosis patients with the history of fractures should actively monitor blood pressure levels and prevent the occurrence of hypertension.

Association between osteoporosis and cardiovascular disease in elderly people: evidence from a retrospective study

“… Chen et al (2023) have shown that the greatly increased risk of hip fracture in hypertension patients exists in both short-term and long-term courses of hypertension. The results of this study displayed that there were statistical differences in blood pressure between the osteoporosis group and the non-osteoporosis group ( P < 0.05), and there was a correlation between hypertension and bone mineral density T-score.…”

“…Osteoporosis is a systemic and metabolic bone disease characterized by low bone mass, compromised bone microarchitecture, and increased bone fragility, ultimately leading to fractures and associated clinical manifestations, such as reduced bone mineral density, degraded bone microstructure, chronic pain, and diminished mobility ( Bover et al, 2018 ; Chen et al, 2023 ). With its highest incidence among middle-aged and elderly individuals, osteoporosis poses a significant burden on this population ( Peng et al, 2022 ).…”