Blood Pressure and Bone Mineral Density in Premenopausal and Postmenopausal Women

Introduction: Previous studies regarding the associations between blood pressure (BP) and bone mineral density (BMD) have shown conflicting results. However, menopausal status and pharmacotherapy may modify this relationship. The objective of this study was to explore the association between systolic BP (SBP) and diastolic BP (DBP) and BMD in pre- and postmenopausal women, and to assess the extent to which this association is mediated by menopausal status and pharmacotherapy. Methods: A cross-sectional study was conducted using a sample of 4,058 pre- and postmenopausal women aged 40 years or older (N = 991 and 3,067, respectively), who participated in NHANES III. BMD measurement of the femur neck was used as the primary outcome measure. Regression models were used to examine the association between SBP or DBP and BMD. Results: The unadjusted models for systolic and diastolic BP were positively and significantly associated with femoral BMD in premenopausal women (p = 0.0039 and p = 0.0065, respectively) as well as in postmenopausal women (p < 0.0001 for both SBP and DBP). After adjusting for covariates in the multivariate models, the association between BP and BMD in postmenopausal women no longer prevailed. In premenopausal women, the association between SBP or DBP and BMD was modified by hormone therapy (p = 0.0278 and p = 0.0025, respectively). Once the stratum-specific adjusted models by hormone therapy use were examined, the association between SBP or DBP and BMD was no longer significant. Conclusions: The study results suggest that there is no link between BP and BMD in pre- and postmenopausal