Abstract
Widespread use of antihypertensive agents in clinical practice necessitates the knowledge of their pleiotropic effects. At the present time there are no sufficient evidences of positive effect of these medications on bone coming from randomized controlled trials; knowledge of additional effects of those drugs on the bone metabolism will allow doctors to choose optimal treatment of hypertension, taking into account the state of bone tissue. At the same time it will also allow to prevent osteoporosis in patients having osteoporosis risk factors or initial signs of bone loss.
 Ten elderly hypertensive women age > 60 years old (64.2±3.6) treated with captopril for a 5-6 years ago while they attending Al Yarmouk Teaching Hospital in Baghdad; in addition, newly-diagnosed hypertensives, and normotensive of the aged-matched women were participated in this study that were conducted during the period (January- May 2014). Measurement of serum calcium, magnesium, inorganic phosphorus, total alkaline phosphatase activity, and parathyroid hormone were done, in addition to spine mineral density and t-score of such bone density by dual energy x-ray absorptiometry. The results of this study showed that there were no significant differences in the serum levels of calcium, magnesium, inorganic phosphorus, total alkaline phosphatase activity, and parathyroid hormone in postmenopausal hypertensive women treated for 5-6 years with captopril compared to newly-diagnosed and to aged-matched normotensive women. In addition, non-significant differences were observed in the level of bone mineral density and t score of bone mineral density in all groups of the study. In conclusion, the present study provides additional knowledge concerning the influence of captopril treatment on some selected parameters of bone metabolism in elderly hypertensive women.
 Keywords: Captopril, Bone metabolism, Elderly women, Hypertension, Dual energy x-ray absorptiometry.
Highlights
Hypertension and osteoporosis are two major age-related disorders that together account for significant morbidity and mortality in the elderly
Hypertensive elderly women treated with therapeutic doses of captopril, for 5-6 years showed non-significant differences (P>0.05) in the levels of serum calcium, magnesium, and inorganic phosphorus compared to normotensive elderly controls and to newlydiagnosed hypertensive women of the agedmatched as shown in table 3
The data presented in table 4 showed nonsignificant differences (P>0.05) in the serum activity of alkaline phosphatase (ALP), and the level of serum parathyroid hormone (PTH) levels in elderly hypertensive women treated for 5-6 years with captopril compared to the corresponding levels in newly-diagnosed and to normotensive control women
Summary
Hypertension and osteoporosis are two major age-related disorders that together account for significant morbidity and mortality in the elderly. Several studies suggested that high blood pressure is associated with abnormalities of calcium metabolism, leading to an increase in calcium movement from bone, thereby increasing the risk of osteoporosis [1,2,3] while, others did not show such association [4,5,6]. This study was designed to investigate the influence of captopril on bone metabolism in elderly hypertensive women; and to add suggestions to that performed by other researchers concerning this respect. The significance of difference among groups of women concerning their age, weight, height and mean arterial blood pressure was tested using Pearson Chi-square test ( 2test) with application of Yate's correction or Fisher Exact test whenever applicable. Statistical significance was considered whenever the P value was equal or less than 0.05 in all data presented in this study
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