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Abstract
Osteoporosis (OP) is characterized by a reduction in bone mass and disruption of skeletal microarchitecture leading to an increased susceptibility to fracture with minimal trauma. The average length of stay in an acute care hospital after a hip fracture is three weeks; one of four patients must remain in long-term care institutions for at least one year; and one of three returns home but must depend on other people or devices for mobility. Furthermore, after a hip fracture there is up to a 20% increased risk of mortality.
Pharmacologic agents to prevent OP include estrogen replacement therapy (ERT), bisphosphonates (alendronate, risedronate, and etidronate), and selective estrogen receptor modulators (raloxifene). Pharmacologic treatments are expensive and the limitations of the current therapies have fuelled interest in alternatives. An optimal agent would be one that decreases bone resorption while also increasing bone formation to have maximal effects on BMD and ultimately fracture, is convenient to take, inexpensive, has minimal adverse effects, is safe for long-term use, and is available world wide. One potential agent is nitric oxide in the form of organic nitrate, the subject of this randomized trial.
The aim of this work is to determine if nitrates can treat osteoporosis in postmenopausal women in comparison to alendronate.