Relationship between indicators of pulse wave and bone mineral density in elderly aged women with uncomplicated hypertension

Abstract

The aim — to perform a comparative analysis of the indices of central aortic pressure and pulse wave, bone mineral density (BMD) in elderly female patients with uncomplicated essential hypertension.Materials and methods. The study involved 30 women with essential hypertension of II stage, 2 degree, of mean age of 69.3 ± 0.9 years, with a post­menopausal duration of 17.7 ± 1.1 years and 25 practically healthy women aged 65.6 ± 1.6 years with a post­menopausal period of 15 ± 1.6 years. All patients underwent general clinical and laboratory examination, daily monitoring of blood pressure (BP) and echocardiography. The parameters of central hemodynamics and arterial stiffness were measured with SphygmoCor (AtCor Medical, Australia). BMD was examined on Hologic Discovery apparatus. To assess the quality of bone tissue (Trabecular Bone Score — TBS), the TBS iNsight technique, developed by Med­Imaps (France), was used.Results and discussion. Patients with essential hypertension and those of the control group were matched by age, body mass index, brachial and central arterial pressure and the level of markers of bone remodeling. A violation in BMD was found in 13 (43.3 %) patients of the main group (in 9 (30 %) women — osteopenia, in 4 — osteoporosis (13.3 %). In the control group, BMD disturbances were detected in 7 (28.5 %) women (4 (16.3 %) had osteopenia, and 3 (12.2 %) — osteoporosis). Patients with hypertension had a positive correlation between PPampl. and BMD indices of the total skeleton, lumbar spine (L1—L4) and the ultra­distal forearm bones, the index of bone tissue remodeling (P1NP) and the quality of trabecular bone tissue — TBS; a negative correlation between the value of the T­test in the total skeleton, lumbar spine and neck of the left femur with the parameters of applanation tonometry (AP, AIx, AIx75) and a positive relationship between AP, AIx and FRAX­all.Conclusions. Elderly women with controlled arterial hypertension and elevated vascular stiffness (according to applanation tonometry) have decreased BMD compared with practically healthy women of comparable age.