Key concepts

Major risk factors for osteoporotic fracture include low bone mineral density, personal history of adult fracture, age, family history of osteoporotic fracture, current cigarette smoking, low body mass index, excessive alcohol use, and chronic glucocorticoid use.

A standardized approach for diagnosing osteoporosis is recommended using central dual-energy x-ray absorptiometry (DXA) measurements.

Both pharmacologic and nonpharmacologic therapies for osteoporosis are aimed at preventing fractures and their complications, maintaining or increasing bone mineral density, preventing secondary causes of bone loss, and improving morbidity and mortality.

'O' All men and women over age 50 be should be considered for pharmacologic treatment if they meet any of the following criteria: history of hip or vertebral fracture, T-score less than or equal to -2.5 at femoral neck or spine, or osteopenia and at least a 3% 10-year probability of hip fracture or at least a 20% 10-year probability of major osteoporosis-related fracture as determined by FRAX.

Adequate calcium and vitamin D intake is essential in prevention and treatment of osteoporosis. Calcium and vitamin D supplements to meet requirements should be added to all drug therapy regimens for osteoporosis.

® Bisphosphonates are first-line therapy for postmenopausal osteoporosis due to established efficacy in preventing hip and vertebral fractures.

Alendronate should be considered first-line treatment for primary osteoporosis in men due to proven benefit in reducing fractures and relative safety.

For prevention of glucocorticoid-induced osteoporosis, bisphosphonate therapy is recommended in all patients who are starting treatment with glucocorticoids (prednisone 5 mg or more daily or equivalent) for at least 3 months. For patients receiving chronic glucocorticoids (prednisone 5 mg or more daily or equivalent), bisphosphonate therapy is also recommended if the bone mineral density is low or if there is a history of fracture.

Blood Pressure Health

Blood Pressure Health

Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...

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