ArticleBMC musculoskeletal disorders2026
The relationship between hypertension and thoracic spine bone mineral density: the Multi-Ethnic Study of Atherosclerosis (MESA).
Article in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
PURPOSE/
introductionHistorically, hypertension (HTN) and osteoporosis, as indicated by bone mineral density (BMD), were viewed as distinct conditions. However, current understanding highlights the role of vascular inflammation and immune cell activation in both diseases. The exact relationship between HTN and BMD, however, remains poorly defined.
methodsParticipants from the MESA study, both with and without hypertension (defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, or the use of antihypertensive drugs), underwent thoracic spine BMD measurement using non-contrast CT chest. Linear regression was used to assess the relationship between BMD and HTN. BMD was also categorized by T-scores (normal, osteopenia, osteoporosis) and analyzed using proportional odds logistic regression. The models were adjusted for variables such as age, gender, race/ethnicity, BMI, and osteoporosis medication use to assess these associations.
resultsAmong the 6,814 participants, those with hypertension (HTN) were older and more likely to be Black and female. Osteoporosis was more prevalent among hypertensive individuals (30% vs. 23%), with a lower mean BMD by 6.23 mg/cc in unadjusted analysis (p < 0.001). However, after adjusting for confounders, the association between HTN and BMD was not significant (p = 0.687). In adjusted models, Black, Chinese, and Hispanic participants had significantly higher BMD compared to White participants. Additionally, higher BMI was associated with increased BMD, while older age was associated with lower BMD.
conclusionThe findings indicate that hypertension does not have an independent association with BMD.
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