Can lisinopril (angiotensin-converting enzyme inhibitor) cause bone demineralization?

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Last updated: May 2, 2025View editorial policy

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From the Guidelines

Lisinopril is not known to cause bone demineralization, and in fact, some research suggests that ACE inhibitors like lisinopril might actually have a neutral or potentially beneficial effect on bone health. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat high blood pressure, heart failure, and to improve survival after heart attacks. Unlike some medications such as corticosteroids, loop diuretics, or certain anticonvulsants that can negatively impact bone density, lisinopril does not have a direct effect on bone metabolism or calcium homeostasis.

Some key points to consider:

  • The relationship between antihypertensives and nutrient status is challenging to elucidate from the current literature, with many different drug families and potential combinations 1.
  • ACE inhibitors like lisinopril might have a beneficial effect on bone health through their impact on the renin-angiotensin-aldosterone system, which plays a minor role in bone remodeling.
  • If you're concerned about bone health while taking lisinopril, it's still important to maintain adequate calcium and vitamin D intake, engage in weight-bearing exercise, and discuss any concerns with your healthcare provider, but the medication itself should not be a cause for concern regarding bone demineralization.
  • The most recent and highest quality study on this topic is from 2021, which found that thiazide use may confer some protection against specific types of fractures, but the evidence for ACE inhibitors like lisinopril is less clear 1.

Overall, based on the available evidence, lisinopril is not likely to cause bone demineralization, and may even have a neutral or beneficial effect on bone health. However, it's always important to discuss any concerns with your healthcare provider and maintain a healthy lifestyle to support bone health.

From the Research

Lisinopril and Bone Demineralization

  • There is no direct evidence in the provided studies that lisinopril causes bone demineralization 2, 3, 4, 5.
  • The studies focus on the effects of lisinopril on blood pressure, renal function, and cardiovascular health, with no mention of its impact on bone density or demineralization 3, 4, 5.
  • However, a study on the concurrent effects of high-intensity interval training and vitamin D supplementation on bone metabolism among women diagnosed with osteoporosis suggests that vitamin D supplementation can help improve bone mineral density (BMD) and slow demineralization 6.
  • It is essential to note that the provided studies do not investigate the relationship between lisinopril and bone demineralization, and therefore, no conclusive evidence can be drawn from these studies 2, 3, 4, 5.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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