Introduction Previous studies have found that some antihypertensive drugs may lower fracture risk. However, the impact of antihypertensive drugs on bone metabolism is not entirely clear. We examined how antihypertensive drugs influenced bone status and bone turnover markers.

Methods We analysed 1632 Japanese men aged ≥65 years from a baseline survey (the FORMEN Study) conducted during 2007–2008 as a part of the Fujiwara-kyo study, a larger prospective cohort study. Associations between antihypertensive drugs (ACE, β-blocker, and thiazide diuretic treatments) and bone metabolism (bone mineral density [BMD] at the lumbar spine [LS] and total hip, serum osteocalcin [OC], and serum tartrate resistant acid phosphatase isoenzyme 5b [TRACP5b]) were investigated cross-sectionally.

Results Proportions of hypertension and subjects taking antihypertensive drugs were 76.0% (n=1240) and 42.4% (n=692), respectively, in the subjects (mean age; 73.0±5.1 years). The numbers of subjects prescribed ACE, β-blockers, and thiazide diuretics were 62, 41, and 12, respectively. Neither BMD nor bone turnover markers varied significantly between those with ACE prescription and those without. We observed significantly higher LS BMD values and significantly lower OC and TRACP5b values in subjects taking β-blockers than in non-users, and the differences in both marker values remained significant after adjusting for confounders (OC: 4.08 [0.18] vs 4.91 [0.03] ng/ml, p=0.039; TRACP5b: 151.23 [0.18] vs 209.98 [0.03] mU/dl, p=0.009). TRACP5b values in subjects with thiazide diuretics also remained significant lower after adjusting for confounders (139.98 [0.33] vs 208.91 [0.03] mU/dl, p=0.007).

Conclusion Bone turnover could be suppressed by β-blocker and thiazide diuretic treatment. Future investigations should be conducted longitudinally.