Association of history of fracture with prehypertension and hypertension: a retrospective case-control study

Meta-analysis of hypertension and osteoporotic fracture risk in women and men

The present meta-analysis synthesized evidence from 10 articles encompassing 28 independent studies to verify the association between hypertension and osteoporotic fracture risk in women and men. Our results indicate that the risk of osteoporotic fracture among individuals with hypertension was higher than that among individuals without hypertension.

INTRODUCTION

Epidemiological studies have suggested that hypertension is related to osteoporotic fracture. However, discrepancies exist in the reported findings. In this study, a systematic review of relevant published articles was conducted to verify the association between hypertension and osteoporotic fracture risk in women and men.

METHODS

PubMed (1953_October 5th, 2016) and Embase (1974_October 5th, 2016) were systematically searched for relevant articles. Odds ratios (ORs) and confidence intervals (CIs) were derived using random effect models. Categorical, subgroup, heterogeneity, publication bias, and meta-regression analyses were conducted.

RESULTS

We analyzed 10 articles encompassing 28 independent studies, 1,430,431 participants, and 148,048 osteoporotic fracture cases. The risk of osteoporotic fracture among individuals with hypertension was higher (pooled OR = 1.33, 95% CI 1.25-1.40; I ² = 72.3%, P < 0.001) than that among individuals without hypertension. The association between hypertension and fracture risk was slightly stronger in women (pooled OR = 1.52, 95% CI 1.30-1.79) than in men (pooled OR = 1.35, 95% CI 1.26-1.44). Studies conducted in Asia revealed results that were consistent with those of studies performed in Europe.

CONCLUSIONS

Hypertension is associated with osteoporotic fracture risk. However, the biological mechanisms underlying the effect of hypertension on osteoporotic fracture remain to be elucidated.