High Blood Pressure May Accelerate Osteoporosis, Bone Aging

Researchers reported that women with osteoporosis had a higher prevalence of high blood pressure. The researchers concluded that “Hypertension was significantly associated with osteoporosis.” A study completed in 2020 reported that bone marrow is affected by hypertension.

High blood pressure can result in bone loss or osteoporosis. It causes a greater amount of calcium than normal to be lost through urine excretion which reduces bone mass. This weakens the bones and increases the risk of fractures.

High blood pressure may accelerate osteoporosis and bone aging, according to a study presented at the 2022 American Heart Association’s Hypertension Scientific Session. The study included 45 mice, divided into four groups:

12 young mice with induced high blood pressure
11 older mice with induced high blood pressure
13 young mice without induced high blood pressure
9 older mice without high blood pressure

The human age equivalent for the young mice was 20 to 30 years and 47 to 56 years for the older mice The mice with induced high blood pressure received the hormone angiotensin II for six weeks. The researchers analyzed bone health for all four groups at the end of the six weeks. They determined bone health by the strength and density of the bone. The young mice with induced high blood pressure had:

A 24% reduction in bone volume
An 18% reduction in thickness of the sponge-like trabecular bone at the end of long bones, such as femurs or the spinal column
A 34% reduction in the estimated ability of bones to withstand different types of force, called failure force, which can lead to weaker bones and fractures later in life

The older mice given the hormone to induce high blood pressure did not have such a significant decline in bone health. “In these mice, being hypertensive at a younger age essentially aged bones as if they were 25 human years older,” Elizabeth Hennen, lead author of the study and Ph.D. candidate in biomedical engineering at Vanderbilt University in Tennessee, told Healthline. “Old mice will experience bone loss whether they are hypertensive or not. This study shows that [high blood pressure] may trigger a pathway like age-related bone loss, effectively aging young bones.” The scientists also said they saw inflammation-signaling molecules, indicating increased inflammation compared to the young mice without high blood pressure. “It has become clear that [high blood pressure] is at least partly an inflammatory disease. We found that both [high blood pressure] and aging activate certain cells implicated in both [high blood pressure] and osteoporosis,” explained Hennen. The researchers said they believe that the results indicate a need to screen people with high blood pressure for osteoporosis. They said they hope new approaches to preventing osteoporosis are developed as knowledge of this topic increases.

What is osteoporosis?

Osteoporosis is the leading cause of fractures in postmenopausal women and older men. Many people do not know they have it until they break a bone, receiving a diagnosis after a routine screening. Fractures most often occur in the hip, vertebrae, spine, or wrist but can occur in any bone. Osteoporosis can occur at any age, but your risk increases as you age. It is most common in non-Hispanic white women, Asian women, and non-Hispanic white men.

The impact of high blood pressure

There are numerous reasons why high blood pressure impacts osteoporosis. “High blood pressure may be more likely to alter the blood supply to the bone and bone marrow, which can possibly stimulate inflammatory mediators,” Dr. Ragavendra Baliga, a specialist in cardiovascular disease and advanced heart failure at The Ohio State University Wexner Medical Center, told Healthline. “The theory is that younger mice have a low inflammatory burden. When increasing their angiotensin II level, we make them hypertensive. There is evidence that hypertension is a pro-inflammatory state,” Dr. Rigved Tadwalkar, a cardiologist at Providence Saint John’s Health Center in California, told Healthline. “Since the young mice were not exposed to significant inflammation prior, the acute inflammatory load might be overwhelming to the bone, leading to processes that favor bone loss.” Previous studies back up the idea that high blood pressure is related to osteoporosis. A 2021 study from China involved 2,039 postmenopausal women. There were 678 women with osteoporosis and 1,361 without the condition. Researchers reported that women with osteoporosis had a higher prevalence of high blood pressure. The researchers concluded that “Hypertension was significantly associated with osteoporosis.” A study completed in 2020 reported that bone marrow is affected by hypertension. The scientists noted clinical evidence of an association between hypertension and osteoporosis. A meta-analysis of 17 articles conducted in 2017, which included almost 40,000 people, found that high blood pressure can reduce bone mineral density in some areas of the body. “Previous studies have also found that medications to reduce [high blood pressure} reduce fractures,” said Baliga.

Ways to reduce osteoporosis risk

While many people do not know they have osteoporosis, there are steps you can take to reduce your risk, according to the National Institutes of Health. They include:

Staying physically active
Regularly participating in weight-bearing exercises, such as walking
Drinking alcohol in moderation
Not smoking
Eating a well-balanced diet rich in calcium and vitamin D
Take medications prescribed for osteoporosis if your doctor believes they are necessary

“It is essential for people to ‘know their numbers,’” Dr. Mahmud Kara, an internist with Kara MD, told Healthline. “Blood pressure is one of the most important numbers, alongside blood sugar and cholesterol, that impact future health outcomes.” “[Checking blood pressure] is prevention to look at modifiable risk factors that can impact the trajectory of your health. For example, genetics that makes you predisposed to high blood pressure is out of your control. Still, certain lifestyle habits, such as smoking, poor diet, or lack of physical activity, are within your control. You can address these when considering your risk of certain diseases,” he added. “If there is a link between high blood pressure, inflammation, and diminishing bone strength,” Kara said, “it would not only be important for someone to know if their blood pressure is high but also how to modify lifestyle factors to manage this high blood pressure and in turn prevent instances of disease later in life.”