Long-term use of angiotensin-converting enzyme inhibitors protects against bone loss in African-American elderly men
Open accessAbstract
Greater bone mineral density was observed after treating hypertension using angiotensin-converting enzyme inhibitor (ACEi). We report decreased rate of bone loss in hypertensive black men using ACEi for 9 years. There may be a gender- and race-specific effect of ACEi in the prevention of age-associated bone loss. Purpose There is evidence of bone mass preservation in patients receiving ACEis, commonly used to treat hypertension. However, limitations of previous studies include being cross-sectional or only including a short-term follow-up of patients using ACEi and including patients with diabetes, which affects bone metabolism. None of the previous studies described effects of ACEi stratified by race. The objective of this study was to investigate differences in changes in bone mineral density (BMD) in older adults who suffer from hypertension and had reported ACEi use during each study visit for at least 9 years during the study, stratified by gender and race. Methods We used data from the Dynamics of Health, Aging and Body Composition (HABC) study, which enrolled 3075 community-dwelling older white and black individuals. We compared changes in femoral neck, total hip, and whole-body BMD after either no use of ACEi (n = 580) or long-term use (at least 9 years) of ACEi (n = 239) in HABC participants with hypertension and no known diagnosis of diabetes mellitus. Results Overall, BMD values significantly decreased for all subgroups over time. In the stratified multivariate analysis, long-term use of ACEi was associated with a reduced rate of decline for all three BMD measures among black men, but no significant effect was observed in the other subgroups. Conclusion Our findings show a gender- and race-specific effect of ACEi in the prevention of age-associated bone loss that warrants further evaluation.
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Rianon et al. found that there are sex- and race-specific effects of ACEi on the prevention of age-related bone loss.
“Rianon et al. [63] found that there are sex- and race-specific effects of ACEi on the prevention of age-related bone loss.”
From A physiology-based mathematical model of the renin-angiotensin system, bone remodeling, and calcium homeostasis: Effects of estrogen and renin-angiotensin system inhibitors (2025) · cites this paper as [63]
The Discussion reports a gender- and race/ethnicity-specific bone-protective effect in Black men, which supports the core of the claim. But the paper says further evaluation is needed, and its Mini Abstract describes the broader sex- and race-specific effect as possible rather than established. (LLM, conf=0.82)
Experimental — accuracy not yet measuredACEi were effective at protecting against bone loss in African-American elderly men.
“Specifically, the authors reported that ACEi were effective at protecting against bone loss in African-American elderly men [63].”
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Cites
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“In vitro studies revealed that angiotensin II (AngII) receptors are expressed in osteoblasts and osteoclasts and that AngII plays a relevant role in the activation of osteoclastogenesis [8, 9].”
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Stadt, M. M., & Layton, A. T. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.05.01.651663
“Rianon et al. [63] found that there are sex-and race-specific effects of ACEi on the prevention of age-related bone loss.”
- Authors
- Rianon, N., Ambrose, C. G., Pervin, H., Garcia, M., Mama, S. K., Schwartz, A. V., Lee, B., & Harris, T.
- Affiliations
- The University of Texas Health Science Center at Houston (US)
- Pennsylvania State University (US)
- University of California, San Francisco (US)
- Baylor College of Medicine (US)
- National Institutes of Health (US)
- Corresponding author
- Rianon, Nahid
- ORCID
- Venue
- Archives of Osteoporosis
- Published
- 2017-10-28
- Volume
- 12
- Issue
- 1
- Pages
- 94-94
- ISSN
- 1862-3514 (ISSN-L)
- 1862-3522
- PMC
- PMC6159934
- OpenAlex
- W2765473249
- Cited by
- 22
- References
- 2
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 4 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 1
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Osteoporosis (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000371)
- National Institute on Aging (Z01AG007390)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
- Keywords
- ACE inhibitors, bone mineral density, bone loss, hypertension, African American men, racial differences, sex differences, aging, femoral neck, hip, long-term drug use
- MeSH terms
- Aged, Aged, 80 and over, Angiotensin-Converting Enzyme Inhibitors, Black or African American, Female, Femur Neck, Humans, Hypertension, Male, Osteoporosis, Prospective Studies, Sex Factors, Time, Time Factors, United States, Bone Density, White People
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