Osteoporosis. Methods to prevent fractures in patients at high risk.

Persons at increased risk for osteoporotic fracture can be identified by clinical assessment and bone-density measurements. General measures (adequate amounts of calcium and vitamin D, along with an active lifestyle) can slow the rate of bone loss and should be recommended for all patients. Estrogen and parenteral salmon calcitonin are approved by the Food and Drug Administration for treatment of osteoporosis; these agents prevent bone loss in most patients and produce modest increases in bone mass, even in patients with advanced disease. Newer agents, such as bisphosphonates, provide additional therapeutic options.