Osteoporosis and Osteoporotic Fracture: Contribution of Hypertension and Anti-hypertension Medications

Hypertension and osteoporosis are two major public health burdens of the general population, which share many of the same risk factors such as advance age, early menopause, smoking and physical inactivity. Many experimental studies suggested that there is biological link between hypertension, antihypertension medications and bone. However, existing human evidence on the contribution of hypertension and anti-hypertension medications to osteoporosis and osteoporotic fracture is either scarce or conflicting. We reviewed existing publications on the topic. Multiple biological mechanisms are involved in the relationship between hypertension and bone, and most of them suggested that hypertension has a deteriorative effect on human skeleton. However, existing human studies on the association between hypertension and bone mineral density are still controversial. In contrast, we found consistent evidence suggesting that hypertension is a risk factor for osteoporotic fracture. There are fewer controversies that Beta-blockers and thiazide diuretics are protective against osteoporosis and osteoporotic fracture. In conclusion, hypertension is a risk factor for osteoporotic fracture and the relationship is likely independent on bone mineral density. The protective effect of beta-blockers and thiazide diuretics is needed to be taken account on the associations. Further studies are highly demanded.