Are beta-blockers useful in the prevention of osteoporotic fractures?

Atherosclerosis and osteoporosis are highly prevalent chronic diseases that affect populations of similar ages who are clinically asymptomatic until complications appear. Therefore, research into new drugs that are useful for both processes and may improve therapeutic compliance appears to be reasonable. beta-blockers are widely used in the treatment of hypertension and its complications, ischemic heart disease and heart failure. Their use has been associated with a decrease in cardiovascular mortality. Experimental data have demonstrated that the sympathetic nervous system inhibits bone formation and increases resorption due to the binding of catecholamines to receptors located in osteoblasts. This produces a decrease in bone mineral density and a higher risk of fractures. The effect is eliminated by the administration of beta-blockers. Retrospective case-control and cohort studies have shown a beneficial effect of beta-blockers on fractures reduction, with a protective effect being observed in eight studies and no effect being found in two studies. The aim of this paper is review these data and the possible role of betablockers in the prevention of osteoporotic fractures in patients with cardiovascular disease.