Nutritional strategies for bone and vascular health in hypertension and osteoporosis

Hypertension and osteoporosis are prevalent chronic conditions that frequently coexist, particularly in aging populations. Increasing evidence indicates that they share interconnected pathophysiological pathways involving calcium metabolism, chronic inflammation, oxidative stress, and hormonal regulation. Diet is a critical adjustable factor that influences the onset and progression of both conditions. This review evaluates the impact of dietary modification, including adherence to the Dietary Approaches to Stop Hypertension (DASH) diet, the Mediterranean diet, sodium restriction, and targeted nutrient intake (e.g., calcium, vitamin D, potassium, and magnesium), on bone mineral density (BMD) in individuals with treated and untreated hypertension. While the DASH diet effectively reduces blood pressure, its potential to lower BMD in the absence of adequate calcium intake warrants caution. In contrast, the Mediterranean diet provides broader nutritional support for both vascular and skeletal health through its anti-inflammatory and antioxidant profile. Diets rich in dairy products, minerals, and bioactive compounds are associated with improved BMD and vascular function. This review combines current evidence, explains mechanistic links between diet, bone, and cardiovascular physiology, and offers evidence-based dietary recommendations to address the coexisting conditions of hypertension and osteoporosis.