Evaluation of the concomitant presence of hypertension and osteoporosis and the importance of screening in Lebanon: a pilot study

Abstract

Objective: Hypertension and osteoporosis are two age-related diseases whose interlinkage are under investigated. In Lebanon, given the high morbidity and mortality rates due to cardiovascular diseases, and the low national health priority given to osteoporosis, we conducted a pilot study to investigate the relationship between the two diseases and the need to screen for them. Design and method: In the summer of 2019, Lebanon participated for a second year in the May Measurement Month. As part of this campaign, a cross-sectional pilot study was launched based on a convenient sampling. It included 730 participants of both genders, aged 18 and above; consent was obtained from all participants. Participants answered a questionnaire about blood pressure and bone health, and were screened for hypertension, following which lifestyle tips were distributed. Results: Our data showed a hypertension prevalence of 41%. When asked about the last time they checked their blood pressure, participants’ response was: 11.4% never, 19.8% more than a year ago, and 68.8% within the last 12 months. 45% of hypertensive participants were not aware of their hypertensive status. Concerning osteoporosis, 8.3% of participants claimed they had it, while 24.8% did not know whether they had it or not. Furthermore, 80.5% mentioned never screening for bone thinning in their lifetime (with 35.6% of them being 43 years and above). A significant association was observed between hypertension and osteoporosis (P = 0.0424). Osteoporosis was a significant risk factor for fractures (P = 0.0068), with an OR of 2.2 CI (1.23–3.99). Height was significantly associated with blood pressure (P < 0.0001), with a higher correlation among participants less than 43 years of age (P < 0.0001). Hypertensive status was significantly associated with bone fractures (P = 0.011). Conclusions: An association exists between hypertension, osteoporosis and bone fractures. This makes screening for both diseases important, given that hypertension is the leading risk factor for cardiovascular death in Lebanon and that the country lacks national comprehensive data about incidence and prevalence of hypertension and osteoporosis. This pilot study can serve as a foundation for an upcoming nationwide screening campaign, and an evidence base for future preventative measures.