Dr Nida E Zahra, Dr Sara Sahar, Dr Momal Jaleel Khan
Background: Hypertension and osteoporosis are the two major age-related conditions. Several studies have shown higher bone mineral density (BMD) in people receiving thiazide diuretics compared with controls. The benefits of angiotensin converting enzyme (ACEI) inhibitors in improving bone metabolism have been confirmed in some clinical trials. Therefore, these medications may be part of a therapeutic regimen for the elderly with hypertension and osteoporosis. Objective: To compare the effects of ACEI and thiazides on BMD when used alone or in combination in elderly hypertensive patients. Place and Duration: In the Medicine Unit-II of Bahawal Victoria Hospital, Bahawalpur for one-year duration from October 2019 to October 2020. Patients and Method: A retrospective comparative study recruiting 171 participants aged 60 years and older. The participants were divided into three groups: Group I: 57 participants receiving thiazides, Group II: 57 participants receiving combined ACEI and thiazides, Group III: 57 participants receiving ACEI. Each group was divided into two subgroups; older and younger than the average age (65) of participants. Patients with systemic diseases or taking medications affecting BMD were excluded from the study. All participants underwent: lumbar spine BMD (L2-L4) and left femoral neck BMD measurements using dual energy X-ray absorptiometry (DEXA) [Lunar DPX DEXA system]. Results: For the BMD T-score in the lumbar region (L2-L4), there was no significant difference between the groups as the whole sample (p-value 0.383), nor between the age subgroups after the division into two subgroups older than the median age. (P-value of 65) (p-value 0.832) and those aged 65 and younger (p-value of 0.259) (the same was found for the z index). Regarding the left femoral BMD T-score, there was no significant difference either between the groups as a whole sample (p-value 0.921) or between the age subgroups divided into two older and younger subgroups (p-value 0.889) (the same was found for to the result from). Conclusion: In the present study, no evidence was found that there is a difference between thiazide therapy and ACEI therapy with respect to their effect on BMD in elderly hypertensive patients when used alone or in combination. Keywords: ACEI, Thiazides, BMD.