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Cardiovascular drugs and bone

Lars Rejnmark1

  • 1Department of Endocrinology and Metabolism C, Aarhus Sygehus, Aarhus, University Hospital, Aarhus, Denmark. rejnmark@post6.tele.dk

Current Drug Safety
|August 12, 2008
PubMed

Insights

Many cardiovascular drugs appear safe for bone health, but some, like loop diuretics, may increase fracture risk. Further research is needed for definitive conclusions on certain medications.

Area of Science:

  • Cardiology
  • Geriatrics
  • Bone Metabolism

Background:

  • Cardiovascular diseases and osteoporosis are prevalent in the elderly.
  • Understanding the bone effects of cardiovascular drugs is crucial for patient safety.

Purpose of the Study:

  • To evaluate the impact of common cardiovascular medications on bone health.
  • To identify potential risks or benefits associated with these treatments.

Main Methods:

  • Review of existing studies, including randomized controlled trials (RCTs) and epidemiological research.
  • Analysis of drug classes such as thiazide diuretics, statins, ACE-inhibitors, and others.

Main Results:

  • Thiazide diuretics, statins, digoxin, ACE-inhibitors, and organic nitrates generally show no adverse bone effects and may improve bone strength.
  • Loop diuretics are associated with increased parathyroid hormone and decreased bone mineral density in RCTs, and increased fracture risk in epidemiological studies.
  • Amiodarone is linked to increased fracture risk in epidemiological studies.
  • Conflicting results exist for oral anticoagulants, beta-blockers, and calcium channel blockers.

Conclusions:

  • Most cardiovascular drugs appear safe for bone, but definitive fracture prevention recommendations cannot be made due to limited RCT data.
  • Loop diuretics and amiodarone warrant caution due to potential negative bone effects and fracture risk.
  • Further research is needed for definitive conclusions on anticoagulants, beta-blockers, and calcium channel blockers.

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