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Elevated blood pressure, antihypertensive medications and bone health in the population: revisiting old hypotheses and exploring future research directions

Lookup NU author(s): Dr Dexter CanoyORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2021, The Author(s).Blood pressure and bone metabolism appear to share commonalities in their physiologic regulation. Specific antihypertensive drug classes may also influence bone mineral density. However, current evidence from existing observational studies and randomised trials is insufficient to establish causal associations for blood pressure and use of blood pressure–lowering drugs with bone health outcomes, particularly with the risks of osteoporosis and fractures. The availability and access to relevant large-scale biomedical data sources as well as developments in study designs and analytical approaches provide opportunities to examine the nature of the association between blood pressure and bone health more reliably and in greater detail than has ever been possible. It is unlikely that a single source of data or study design can provide a definitive answer. However, with appropriate considerations of the strengths and limitations of the different data sources and analytical techniques, we should be able to advance our understanding of the role of raised blood pressure and its drug treatment on the risks of low bone mineral density and fractures. As elevated blood pressure is highly prevalent and blood pressure–lowering drugs are widely prescribed, even small effects of these exposures on bone health outcomes could be important at a population level.

Publication metadata

Author(s): Canoy D, Harvey NC, Prieto-Alhambra D, Cooper C, Meyer HE, Asvold BO, Nazarzadeh M, Rahimi K

Publication type: Article

Publication status: Published

Journal: Osteoporosis International

Year: 2022

Volume: 33

Issue: 2

Pages: 315-326

Print publication date: 01/02/2022

Online publication date: 13/10/2021

Acceptance date: 01/10/2021

Date deposited: 24/11/2022

ISSN (print): 0937-941X

ISSN (electronic): 1433-2965

Publisher: Springer Science and Business Media Deutschland GmbH


DOI: 10.1007/s00198-021-06190-0

PubMed id: 34642814


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