Hypertension as a risk factor for hip fracture

To the Editor: Arterial hypertension is a chronic disease in which prevalence increases with age, as occurs in osteoporosis. It is clinically silent and is only revealed in the form of complications, an aspect that it also shares with osteoporosis. Various alterations of calcium metabolism have been described in association with hypertension; such alterations can cause decreased bone mass, the principal determining factor of fracture.1,2 Another important factor is the occurrence of falls. Hypertensive patients may experience a greater number of falls resulting from fainting associated with diminished baroreflex sensitivity or hypotension secondary to therapy.3,4 The purpose of this study was to assess the effect of hypertension and its various therapeutic alternatives on the risk of hip fracture. After study approval by the medical institutional review board of the Rio Hortega University Hospital, a medical records search identified all patients admitted to the hospital for hip fracture from 1 January 1997 through 31 December 2001. The exclusion criteria were age <65 years and fracture related to a pathologic condition or caused by high-impact traumatic injury. The control group was obtained from the cohort Hortega.5 Men and women between 18 and 80 years were selected from the city census. There was 3004 persons >65 years of age, 1538 women and 1466 men. Only those subjects >65 years of age and without hip fracture were included. Demographic information for the patients and control subjects, number of comorbid conditions, and medications were obtained from the medical records reviewer.