High blood pressure is associated with increased risk of future fracture, but not vice versa

Area of Science:

• Epidemiology
• Gerontology
• Public Health

Background:

• The relationship between hypertension and fracture risk is complex and often shows discrepancies in research.
• Previous studies primarily focused on hypertension predicting future fractures, with less attention to fractures predicting incident hypertension.

Purpose of the Study:

• To investigate the bidirectional association between hypertension and fracture risk.
• To determine if a history of hypertension predicts future fractures.
• To examine if a history of fractures predicts the incidence of hypertension.

Main Methods:

• Utilized data from the China Health and Nutrition Survey (CHNS) prospective cohort (1997-2015).
• Included adult participants with baseline data from 1997, 2000, 2004, or 2006, with outcomes assessed in 2015.
• Employed Cox proportional hazards models to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs).

Main Results:

• Hypertension history was associated with an increased risk of future fractures across all study periods (e.g., adjusted HR 1.40, 95% CI 1.04-1.88 for 2000-2015).
• Fracture history did not show a significant association with the incidence of hypertension (e.g., adjusted HR 1.09, 95% CI 0.85-1.38 for 2006-2015).

Conclusions:

• A history of hypertension is a significant risk factor for future fractures.
• Fractures do not appear to be a risk factor for developing hypertension.
• Findings highlight the importance of managing hypertension to prevent fractures.