Hypertension & Osteoporosis

Updated: May 27, 2024

When most people consider how to improve their bone health, blood pressure typically isn’t the first thing that comes to mind. We all know blood pressure can impact heart health, but how does it influence bone structure? 

Although the two conditions may not seem intuitively connected, studies show that there’s a significant association between high blood pressure and osteoporosis [1][2]. And here’s something even more surprising – nearly half of all adults in the US have hypertension and don’t even know it [3]!

But don’t worry, with the right knowledge and lifestyle choices, you can keep your blood pressure stable and your bones healthy and strong.

How Hypertension Affects Your Bone Health

What’s your blood pressure?

This vital statistic is the force your circulating blood puts on your blood vessel walls. A normal reading is lower than 120/80 mmHg – the systolic reading on the left (the pressure in your arteries during a heartbeat) and the diastolic on the right (the pressure in between heartbeats when your heart is at rest). So, make sure to ask your doctor to check your blood pressure at your next visit. It’s a vital step in maintaining a healthy lifestyle.

Is it too high?

Having a blood pressure reading above 120/80 mmHg indicates high blood pressure. Although it’s normal for your blood pressure to vary throughout the day, when consistently high numbers are seen, you may be diagnosed with hypertension. This is a serious condition, as it can lead to a variety of health risks, including heart disease, heart attack, and stroke.

Some doctors disagree…

Healthcare practitioners may be a bit divided when it comes to diagnosing high blood pressure, depending on the guidelines they choose to follow. For instance, according to the 2003 Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, blood pressure consistently higher than 140/90 mm Hg signals high blood pressure. But the 2017 American College of Cardiology/American Heart Association guidelines suggest that if your blood pressure is 130/80 mm Hg or above, then you’ve got high blood pressure [4]!

How hypertension affects your bones

But get it checked anyway.

Some people with high blood pressure may experience symptoms like a pounding headache, feeling like they can’t catch their breath, or even a surprise nosebleed! While these symptoms can be alarming, many people don’t know they have high blood pressure until it’s checked [5].

What causes your blood pressure to skyrocket?

It’s usually a combination of unhealthy lifestyle choices that have been piling up over time. You know, like spending too much time on the couch, stress eating, indulging in too many happy hour drinks, and eating a lot of salty snacks.

The problem is that while hypertension may not be top of mind for you, when this condition goes unchecked it can cause a host of serious problems like organ damage and potentially compromising cardiovascular health. And, of course, it can impact the health of your bones.

Let’s explore that connection deeper.

The Hypertension-Osteoporosis Link

Nothing in your body happens in a vacuum. When one system becomes imbalanced, you can be sure that there will be consequences elsewhere – which (surprise, surprise) happens to be the case for hypertension and osteoporosis. 

While we’re still figuring out exactly why, studies show a clear association between these two conditions. That said, we do have some understanding of how increased blood pressure may be slowly wearing down your bones.

Let’s take a look at what we know so far.

The first connection between osteoporosis and hypertension involves calcium homeostasis. One of the side effects of high blood pressure is an increased loss of calcium in your urine. As you know, calcium is an essential mineral for bone health, meaning that anything compromising the calcium status in your body is a threat. 

How does urinary calcium relate to bone calcium? As your body loses calcium via urinary excretion, it begins to pull stored calcium from your bones to maintain calcium homeostasis in your blood. 

Of course, if hypertension continues along with calcium loss, your body is constantly draining your bones of this precious mineral which would set the stage for bone loss and osteoporosis [6][7]. 

Another connection between osteoporosis and hypertension involves the internal environment that hypertension creates – it’s like trying to build a house in the middle of a hurricane. This pesky condition creates a slew of oxidative stress and inflammation, which can really throw a wrench into the balance of bone regeneration and breakdown. Not a great combo for keeping your bones strong [8]!

Blood Pressure Medication Can Help Your Bones Too!

No surprise here; medications that lower your blood pressure can also help support your bone mineral density. By reducing hypertension and, therefore, eliminating the loss of urinary calcium, your bones are better able to hold on to their minerals, resulting in improved bone mineral density. 

That said, there are several different types of blood pressure medications, and studies suggest that thiazides or beta-blockers may show superior protection of BMD when compared to other types of hypertensive medications [9][10].

diet to support bone mineral density reducing hypertension

Natural Ways to Prevent Hypertension

Eat Food High In Riboflavin

Riboflavin is a super-important B vitamin that helps your body do all kinds of cool stuff, such as: 

  • Harnessing fat for fuel
  • Helping your body absorb vital minerals like iron and zinc
  • Breaking down cholesterol
  • Allowing your body to get all the goodness from fat-soluble vitamins A, D, E, and K

Riboflavin does it all!

That’s right! When it comes to hypertension, riboflavin is a major player! It helps convert vitamin B6 into its active form, P5P, which in turn activates folate – an essential piece of the methylation puzzle. Methylation helps keep homocysteine levels in check – and when that inflammatory compound goes up, so does blood pressure. In other words, riboflavin is a key nutrient for optimal methylation pathways. But hey, not all of us have pathways that work perfectly – so it’s important to keep an eye on your homocysteine levels.

For people with the MTHFR gene (about 1 out of every 4 of us), things can be a bit trickier. The MTHFR gene helps turn folate into a usable form in the body, but if it’s paired with low riboflavin levels, the risk of hypertension skyrockets up to a whopping 300% [11][12][13][14]. 

But here’s the good news; when people are able to acquire adequate riboflavin, the risk is substantially lowered. 

Some yummy sources of riboflavin include…

  • Soy milk
  • Whole milk
  • Wild Atlantic salmon
  • Leafy greens
  • Almonds
  • Mushrooms
  • Cauliflower
  • Broccoli
  • Asparagus
  • Spirulina

If you want to keep your blood pressure in the healthy zone, don’t forget about the potassium and sodium balance! Many of us get far too much sodium while lacking potassium-rich foods. To correct this balance, watch your salt intake and add more potassium-rich foods to your diet [15][16]. Here’s a few of my favorites. 

  • Dried apricots
  • Lentils 
  • Acorn squash 
  • Raisins
  • Potatoes 
  • Banana
  • Spinach
  • Milk
  • Chicken
  • Yogurt

Live a Heart-Friendly Lifestyle

Beyond just your diet, there are other elements that can affect your blood pressure like ensuring a good night’s rest, controlling your stress levels, not smoking, and drinking in moderation.

Get an early night

A good night’s sleep can do wonders for your health. Not only does it make you feel amazing, but it can also help keep your blood pressure in check. When you sleep, your blood pressure naturally dips due to decreased sympathetic output – it’s like a mini heart health boost! But if you’re not getting enough shut-eye, you miss out on this dip, which can lead to high blood pressure and other cardiovascular risk factors. 

So, how can you get a better sleep? Unplugging your devices a few hours before bedtime is a great place to start; eating a lighter dinner can help too. Plus, make sure your bedroom is set to the perfect temperature – somewhere between 60 to 67 degrees Fahrenheit [17].

going to bed early to help with hypertension

Manage Stress

Due to your body’s ancient adaptation, in the stress response, there is a release of hormones that increase heart rate and blood pressure. 

For your ancestors that were running from predators in the wild, this would have been a fantastic way to increase energy and stamina. However, today’s stressors tend to require less physical output and more mental and emotional engagement [18]. 

While you may not be able to eliminate stressors in your life, you can certainly make efforts to manage your stress response. Some ways to lower your body’s reactivity to stress include meditation, yoga, and breathwork. You could also talk to a friend or mental health practitioner and figure out how to manage your stressors while keeping your body in balance.

Skip happy hour

Alcohol can raise blood pressure and may even reduce the effectiveness of blood pressure medications. If you keep it to just one (for the ladies) or two (for the gents) drinks a day, you can keep your blood pressure in check. For those of you who use a drink or two to unwind after a tough day, try giving some of the stress-reducing activities listed above a try and see if that can help take the edge off before you pour yourself a drink [18][19].

Ditch the smokes

Lighting up a cigarette might give you a quick hit of energy, but it can have a long-lasting impact on your blood pressure and heart rate. Nicotine triggers your adrenal glands to release catecholamines, which can lead to an immediate spike in blood pressure and heart rate. Quitting smoking not only helps lower blood pressure but also supports overall heart health. So ditch the smokes and enjoy a longer, healthier life [20]!


If you’re keeping an eye on your bone health, make sure to monitor your blood pressure, too! Hypertension can be a silent enemy, so check it regularly and watch out for signs. To keep your heart and bones in tip-top shape, incorporate regular physical activity into your lifestyle, eat a nutritious and varied diet, and get plenty of restful sleep each night.

To learn more about bone health and how to live a healthy, balanced life, sign up for the AlgaeCal Newsletter for more tips and the latest research.


What are the warning signs of hypertension?

Hypertension can occur without any signs or symptoms. However, in severe hypertension, you may notice headache, nose bleeds, and difficulty breathing.

What are the 3 main causes of hypertension?

The three leading causes of hypertension include 1. Obesity or being overweight due to a sedentary lifestyle and poor dietary habits 2. Atherosclerosis (the buildup of cholesterol, fat, and other substances on the artery walls), and 3. Consuming too much sodium and not enough potassium.

Can high blood pressure affect your bones?

Yes, high blood pressure can deplete your bones of calcium, reduce your bone mineral density (BMD), and increase your risk for osteoporosis and fractures.

Can blood pressure meds cause bone loss? Which antihypertensive is good for osteoporosis?

Blood pressure meds may help protect your bones by diminishing calcium loss in urine, helping you maintain bone mineral density (BMD). Of the different classes of drugs, studies show that thiazides are the most effective in helping with BMD.

Article Sources

  1. Chai, Hao, et al. "Hypertension is associated with osteoporosis: a case-control study in Chinese postmenopausal women." BMC Musculoskeletal Disorders 22.1 (2021): 1-7.
  2. Ye, Ziliang, Haili Lu, and Peng Liu. "Association between essential hypertension and bone mineral density: a systematic review and meta-analysis." Oncotarget 8.40 (2017): 68916.
  3. https://www.cdc.gov/bloodpressure/facts.htm
  4. https://www.cdc.gov/bloodpressure/about.htm
  5. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410
  6. Nakagami, Hironori, and Ryuichi Morishita. "Hypertension and osteoporosis." Clinical calcium 23.4 (2013): 497-503.
  7. Cappuccio, Francesco P., et al. "Unravelling the links between calcium excretion, salt intake, hypertension, kidney stones and bone metabolism." Journal of nephrology 13.3 (2000): 169-177.
  8. Do Carmo, Luciana, and David G. Harrison. "Hypertension and osteoporosis: Common pathophysiological mechanisms." Medicine in Novel Technology and Devices 8 (2020): 100047.
  9. Hijazi, Nermeen, and Zaynab Alourfi. "Association between hypertension, antihypertensive drugs, and osteoporosis in postmenopausal Syrian women: a cross-sectional study." Advances in medicine 2020 (2020).
  10. Puttnam, Rachel, et al. "Association of 3 different antihypertensive medications with hip and pelvic fracture risk in older adults: secondary analysis of a randomized clinical trial." JAMA internal medicine 177.1 (2017): 67-76.
  11. McNulty, Helene, et al. "Riboflavin, MTHFR genotype and blood pressure: a personalized approach to prevention and treatment of hypertension." Molecular aspects of medicine 53 (2017): 2-9.
  12. Ward, Mary, et al. "Impact of the common MTHFR 677C→ T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension: evidence from the JINGO project." BMC medicine 18.1 (2020): 1-11.
  13. Field, Martha S., Regan L. Bailey, and Patrick J. Stover. "Unrecognized riboflavin deficiency and evidence for cascading effects on vitamin B-6 status." The American Journal of Clinical Nutrition 116.6 (2022): 1472-1473.
  14. Jarrett, Harry, et al. "Vitamin B-6 and riboflavin, their metabolic interaction, and relationship with MTHFR genotype in adults aged 18–102 years." The American Journal of Clinical Nutrition 116.6 (2022): 1767-1778.
  15. Perez, Vanessa, and Ellen T. Chang. "Sodium-to-potassium ratio and blood pressure, hypertension, and related factors." Advances in nutrition 5.6 (2014): 712-741.
  16. https://ods.od.nih.gov/factsheets/Potassium-HealthProfessional/
  17. Calhoun, David A., and Susan M. Harding. "Sleep and hypertension." Chest 138.2 (2010): 434-443.
  18. Kulkarni, Sameer, et al. "Stress and hypertension." WMJ: official publication of the State Medical Society of Wisconsin 97.11 (1998): 34-38.
  19. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974
  20. Primatesta, Paola, et al. "Association between smoking and blood pressure: evidence from the health survey for England." Hypertension 37.2 (2001): 187-193.

Article Comments

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  1. Georgia Clark

    May 20, 2023 , 7:50 am

    I am so thankful for this article you sent me,

  2. Linda Sanders

    May 20, 2023 , 1:04 pm

    thank you for this information, it has given me clear understanding of blood pressure, bones and osteoporosis. I’m sure there is more to understand but this much I know and learning will benefit me in my life tremendously and help me live out my life with understanding to make it even better. thank you so much! !

  3. Brianne AlgaeCal

    May 23, 2023 , 9:42 am

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  4. Mahin

    May 20, 2023 , 6:12 pm

    It is very informative article and I learned new things that I didn’t know before.
    Thank you

  5. Kathleen Francis

    May 20, 2023 , 6:41 pm

    Interesting facts about high blood pressure and bone loss help me to understand clearly about how to prevent them before serious consequences can happen.
    Thanks for your great article😁

  6. Brianne AlgaeCal

    May 23, 2023 , 9:52 am

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    May 21, 2023 , 12:39 pm

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  8. Judith Small

    June 29, 2023 , 8:54 am

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  9. Megan @ AlgaeCal

    June 29, 2023 , 11:18 am

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  10. Debbie Kropf

    June 1, 2024 , 10:44 am

    Has anyone had made comments regarding the strontium supplement as part of teh ALgae cal plus supplement ot increase bone density and an increase in blood pressur

  11. Yoori AlgaeCal

    June 3, 2024 , 6:03 pm

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    – Yoori

This article features advice from our industry experts to give you the best possible info through cutting-edge research.

Lara Pizzorno
MDiv, MA, LMT - Best-selling author of Healthy Bones Healthy You! and Your Bones; Editor of Longevity Medicine Review, and Senior Medical Editor for Integrative Medicine Advisors.,
Dr. Liz Lipski
PhD, CNS, FACN, IFMP, BCHN, LDN - Professor and Director of Academic Development, Nutrition programs in Clinical Nutrition at Maryland University of Integrative Health.,
Dr. Loren Fishman
MD, B.Phil.,(oxon.) - Medical Director of Manhattan Physical Medicine & Rehabilitation and Founder of the Yoga Injury Prevention Website.,
Prof. Didier Hans
PHD, MBA - Head of Research & Development Center of Bone Diseases, Lausanne University Hospital CHUV, Switzerland,