High blood pressure may lead to more rapid bone loss

High blood pressure may lead to more rapid bone loss

New research shows that high blood pressure may accelerate bone ageing.

  • Researchers in mice discovered that high blood pressure could lead to significant bone loss.
  • High systolic (top number) and diastolic (bottom number) pressures were associated with increased trabecular separation and decreased connectivity density in the femur of young mice. However, these changes did not occur in older mice. These findings suggest that high systolic and diastolic pressures affect the microarchitecture of long bones in a manner that mimics ageing.
  • They suggested that early detection and treatment of hypertension could prevent the loss of bones due to osteoporosis.

High blood pressures induce similar changes in bones of younger mice as seen in older ones, according to new research from UC San Francisco scientists. The study found that when hypertension was created in young mice, their bones lost calcium and became brittle, just like in older mice. The researchers say these findings suggest that treating hypertension early may prevent age-associated diseases such as osteoporosis.

Inflammation associated with high BP was linked to bone loss in mice.

“The idea behind our research is to understand what happens in bones during the process of ageing and why they break down,” says senior author Dr Elizabeth Maria Hennen. “We know that inflammation plays a role in causing osteoporotic disease, so we wanted to see if it could play a role in increased fracture risk.” Inflammation is known to cause increased production of cytokines in the body, including IL1B and TNFa, which can increase the breakdown of collagen and calcium in bones.

To test whether inflammation increases the likelihood of developing osteoporotic disease and breaks down bones, the authors looked at two mouse models: one type had an inflammatory condition similar to rheumatoid arthritis, and another type had a genetic mutation that causes high blood pressure. Both models showed higher levels of inflammation and more significant loss of trabecular and cortical bones in the femurs. When the authors examined the bones of the hypertensive animals, they found that the amount of inflammation in the tissue surrounding them was much higher than in the tissues around the bones of the normotensive animals. They also saw signs of increased activity of enzymes breaking down collagen and calcium in the bones of the hypertensives. These results suggest that inflammation may contribute to the development of osteoporotic disease in humans and that anti-inflammatories might help prevent or treat osteoporotic disease.

Researchers examined mouse bones after they had been exposed to high blood pressure for 6 weeks. They then compared them to control group bones. Using mathematical formulas, they estimated the effect of high blood pressure on the structure and strength of the bones.

Compared to the typical young mouse group, the hypertensive young mouse group showed significantly reduced BV/TV (24%), Tb.Th (18%) and EF (34%).

"Failure forces the body to adapt by weakening the bones," says Dr John Hennen, an orthopaedic surgeon at the University of Michigan Health System. "In the spine, weak bones can cause vertebral fractures."

The researchers found that the old, normotensive, and hypertensive animals had a lower bone mineral density than their younger counterparts. However, they discovered that the old, normo­tensive, and hypertensive groups had a poorer quality of bone than the young, normotensive group.

Hypertension in young mice caused their bones to become significantly older than usual by the time they reached adulthood.

To determine whether hypertension affects the development of osteoporosis in young female rats, scientists used microscopy and immunohistochemistry to analyze the bones of these animals. They discovered increased inflammation in the bones of hypertensive young females compared to their normotensive counterparts.

“This increase of active immune cells shows that the older mice are generally more inflamed than younger mice and that a continuous inflammatory status, whether they have high blood pressures or not, may harm bones,” says Dr Hennen. “High blood pressures were adjusting the remodelling processes towards losing bones, rather than gaining them or maintaining equilibrium, in the hypertensives young mice. Consequently, bones would be weaker, increasing the risk for osteoporotic fractures. In humans, we should check for osteoporosis among patients with hypertension.” Dr Hennen explains that these findings could provide insights into identifying the immune cells and mechanisms involved in human skeletal health. These discoveries may lead to new ways to prevent osteoporosis in early adulthood.

It’s important to note that this type of research is just descriptive; there needs to be further investigation into how exactly each type of cell contributes to bone health. We don't know if a similar relationship holds for people, so future studies must examine human subjects.

Authors include Ming Fang Ao, PhD; Nestor De La Visión, PhD; Wei Chen, MD, PhD; Sasidhar Uppu­ganti, MS; Elizabeth Rendina-Rueedy, PhD; Jeffry S. Nymann, PhD; and David G. Harrison, MD.

The study was funded jointly by the National Institutes of Health, Vanderbilt University, and Vanderbilt University Medical Center (VUMC).

Original Article

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