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Reduced fracture risk in users of thiazide diuretics.
Calcif Tissue Int 2005; 76(3):167-75CT

Abstract

Thiazide diuretics (TD) reduce renal calcium excretion and may increase bone mineral density. A reduced fracture risk has been reported in some but not all studies. The aim of this study was to assess fracture risk in users of TD. The study design was nationwide population-based pharmacoepidemiological case-control study with fracture in year 2000 as outcome and use of TD during the previous 5 years as the exposure variable. Individual use of TD was derived from the Danish National Pharmacological Database and related to fracture data from the National Hospital Discharge Register. These data were combined with information on use of other drugs, social status, working status, income, educational status, contacts with general practitioners and practicing specialists, and comorbidity. A total of 64,699 patients (age = 40 years) who sustained a fracture during the year 2000 were compared to 194,111 age- and gender-matched controls. After adjustment for potential confounders, current use of TD was associated with a 10% (95% confidence interval [CI], 7% to 12%) reduced risk of any fracture and a 17% (95% CI 11% to 23%) reduced risk of forearm fractures. In former TD users, the risk reduction was slightly less pronounced. Similar results were found in men and women, and in subjects younger or > or = 65 years of age. Dose-effect analysis revealed a decreased risk of any fracture and fractures at the forearm and hip with an increased number of redeemed defined daily dosages (DDDs) of TD. Therefore, use of more than 2000 DDD was associated with a 19% (95% CI 10% to 27%) decreased hip fracture risk. We conclude that use of TD is associated with a significantly reduced fracture risk.

Authors+Show Affiliations

Department of Endocrinology and Metabolism, Aarhus University Hospital, Aarhus Sygehus, Tage Hansens Gade 2, DK-8000 Aarhus C, Denmark. rejnmark@post6.tele.dkNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15719207

Citation

Rejnmark, L, et al. "Reduced Fracture Risk in Users of Thiazide Diuretics." Calcified Tissue International, vol. 76, no. 3, 2005, pp. 167-75.
Rejnmark L, Vestergaard P, Mosekilde L. Reduced fracture risk in users of thiazide diuretics. Calcif Tissue Int. 2005;76(3):167-75.
Rejnmark, L., Vestergaard, P., & Mosekilde, L. (2005). Reduced fracture risk in users of thiazide diuretics. Calcified Tissue International, 76(3), pp. 167-75.
Rejnmark L, Vestergaard P, Mosekilde L. Reduced Fracture Risk in Users of Thiazide Diuretics. Calcif Tissue Int. 2005;76(3):167-75. PubMed PMID: 15719207.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced fracture risk in users of thiazide diuretics. AU - Rejnmark,L, AU - Vestergaard,P, AU - Mosekilde,L, Y1 - 2005/02/23/ PY - 2004/04/27/received PY - 2004/09/14/accepted PY - 2005/2/19/pubmed PY - 2005/7/12/medline PY - 2005/2/19/entrez SP - 167 EP - 75 JF - Calcified tissue international JO - Calcif. Tissue Int. VL - 76 IS - 3 N2 - Thiazide diuretics (TD) reduce renal calcium excretion and may increase bone mineral density. A reduced fracture risk has been reported in some but not all studies. The aim of this study was to assess fracture risk in users of TD. The study design was nationwide population-based pharmacoepidemiological case-control study with fracture in year 2000 as outcome and use of TD during the previous 5 years as the exposure variable. Individual use of TD was derived from the Danish National Pharmacological Database and related to fracture data from the National Hospital Discharge Register. These data were combined with information on use of other drugs, social status, working status, income, educational status, contacts with general practitioners and practicing specialists, and comorbidity. A total of 64,699 patients (age = 40 years) who sustained a fracture during the year 2000 were compared to 194,111 age- and gender-matched controls. After adjustment for potential confounders, current use of TD was associated with a 10% (95% confidence interval [CI], 7% to 12%) reduced risk of any fracture and a 17% (95% CI 11% to 23%) reduced risk of forearm fractures. In former TD users, the risk reduction was slightly less pronounced. Similar results were found in men and women, and in subjects younger or > or = 65 years of age. Dose-effect analysis revealed a decreased risk of any fracture and fractures at the forearm and hip with an increased number of redeemed defined daily dosages (DDDs) of TD. Therefore, use of more than 2000 DDD was associated with a 19% (95% CI 10% to 27%) decreased hip fracture risk. We conclude that use of TD is associated with a significantly reduced fracture risk. SN - 0171-967X UR - https://www.unboundmedicine.com/medline/citation/15719207/Reduced_fracture_risk_in_users_of_thiazide_diuretics_ L2 - https://dx.doi.org/10.1007/s00223-004-0084-2 DB - PRIME DP - Unbound Medicine ER -