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Intermittent Use of Nitrates Increases Bone Mineral Density: The Study of Osteoporotic Fractures
Author(s) -
Jamal Sophie A.,
Browner Warren S.,
Bauer Douglas C.,
Cummings Steven R.
Publication year - 1998
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1359/jbmr.1998.13.11.1755
Subject(s) - medicine , bone mineral , confidence interval , heel , confounding , osteoporosis , nitric oxide , hip fracture , bone density , endocrinology , anatomy
Nitric oxide slows bone remodeling and bone loss in animals. Because nitroglycerin and other nitrates increase nitric oxide levels, we hypothesized that nitrate use may be associated with greater bone mineral density (BMD) and decreased risk of fracture in humans. Further, intermittent nitrate use may be associated with greater benefits than daily nitrate use, which results in tachyphylaxis. We tested this hypothesis using data from the Study of Osteoporotic Fractures. We prospectively studied 6201 elderly women of whom 317 took nitrates on a daily basis and 74 used them intermittently. We measured BMD at the hip and the heel and adjusted all comparisons for multiple potential confounders. We found that women taking daily nitrates had slightly greater hip BMD (difference, 1.3%; 95% confidence interval [CI], 0.14–4.1%) but the same heel BMD (difference, 0%; 95% CI −2.6–2.6%) as nonusers. By contrast, women using nitrates intermittently had substantially greater hip (difference, 2.6%; 95% CI, 0.4–6.8%) and heel BMD (difference, 5.3%; 95% CI, 2.6–11%) than nonusers. This study suggests that the intermittent administration of nitrates may enhance BMD.