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Bone microarchitectural degradation in hypertensive patients: a population-based study.
Fabio Bioletto1, Martina Bollati2, Marco Barale3
1Division of Endocrinology, Diabetes and Metabolism, Department of Medical Sciences, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy. fabio.bioletto@unito.it.
Archives of Osteoporosis
|April 27, 2026
Summary
Hypertension is linked to poorer bone microarchitecture, not lower bone density. This bone quality degradation may explain increased fracture risk in hypertensive individuals.
Area of Science:
- Bone biology and osteoporosis research.
- Cardiovascular health and its systemic effects.
Background:
- Hypertension is a known risk factor for fractures, but its impact on bone mineral density (BMD) is debated.
- Limited data exist on how hypertension affects bone microarchitectural quality.
- The effects of antihypertensive drugs on bone quality are not well understood.
Purpose of the Study:
- To investigate if hypertensive patients exhibit altered bone microarchitecture using trabecular bone score (TBS).
- To explore the relationship between antihypertensive medications and TBS as a secondary objective.
Main Methods:
- Utilized data from 7053 subjects from the National Health and Nutrition Examination Survey (NHANES) 2005-2008.
- Calculated TBS from lumbar spine dual-energy X-ray absorptiometry (DXA) images.
- Performed regression analyses to assess associations between hypertension, medications, and bone outcomes, adjusting for confounders.
Main Results:
- Hypertension was independently associated with significantly lower TBS, indicating degraded bone microarchitecture.
- No significant association was found between hypertension and BMD at the lumbar spine, total hip, or femoral neck.
- No specific class of antihypertensive medications showed a significant association with TBS.
Conclusions:
- Hypertension is associated with impaired bone microarchitecture but not reduced bone mass.
- No significant link was identified between antihypertensive drug classes and TBS.
- Observed associations between certain antihypertensive medications and BMD align with prior research.
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