Hypertension and osteoporosis: Common pathophysiological mechanisms

Hypertension is a common disease affecting almost one half of adults and is a major cause of morbiditiy and mortality. Substantial epidemiological data suggest that there is a relationship between hypertension and osteoporosis although the underlying mechanisms remain poorly defined. It is now clear that inflammation and immune activation contribute to the end-organ damage that occurs in hypertension, and that factors in the hypertensive environment, including increased sympathetic outflow, cytokines, angiotensin II, oxidative stress and vascular disease can affect bone metabolism and the balance between bone generation and resorption. Many of these events likely contribute to osteoporosis. In this review we will consider these factors and discuss potential diagnostic and therapeutic measures that might be implemented to improve these diseases.