A 73-year-old woman with controlled hypertension sees you for a routine visit. Five months ago, she broke her humerus after tripping over a bag of groceries. She has completely recovered. Although she fell 4 times in the last year, this was her first fracture. She does not smoke, drinks alcohol occasionally and enjoys line-dancing twice weekly. Her medications include a calcium-channel blocker and a thiazide diuretic. She has never taken corticosteroids. Her weight is 67 kg, height 165 cm and body mass index 25. Her blood pressure is 135/80 mm Hg, with no evidence of orthostatic drop. Measurement of bone mineral density with the use of dual-energy x-ray absorptiometry reveals T scores of -2.2 at the lumbar spine and -2.1 at the femoral neck. What would your approach be to the management of this patient?
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