In which population is the decrease in bone mass most pronounced?

The decrease in bone mass is most pronounced in postmenopausal women due to the significant hormonal changes that occur after menopause. During this time, there is a marked decline in estrogen levels, which plays a crucial role in maintaining bone density. Estrogen helps to inhibit bone resorption—a process where bone is broken down and its minerals released into the bloodstream. When estrogen levels drop post-menopause, this inhibition is reduced, leading to a faster rate of bone loss.

In contrast, while frequent falls may increase the risk of fractures, they do not directly contribute to the rate of bone mass loss. Similarly, men over 50 experience some decline in bone density, but the rate is typically less pronounced than in postmenopausal women due to higher levels of testosterone, which can also provide some protective effects against bone loss. The presence of hypertension itself does not inherently cause a decrease in bone mass, although certain medications used to treat hypertension may have side effects that affect bone health. Thus, the option regarding postmenopausal women accurately reflects the population most impacted by significant bone mass reduction.