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beta-Blocker use, BMD, and fractures in the study of osteoporotic fractures.
J Bone Miner Res. 2005 Apr; 20(4):613-8.JB

Abstract

A role for osteoblastic beta-adrenoreceptors in bone regulation is suggested by the finding that beta-blockers increase bone mass in mice. We studied the association of beta-blocker use with BMD and fractures in the Study of Osteoporotic Fractures. beta-blocker use and BMD are unrelated in this cohort, and associations with fracture risk are inconsistent.

INTRODUCTION

The central nervous system has been shown to regulate bone mass in mice, possibly by way of the beta(2)-adrenoreceptors on osteoblasts. beta-blockers have been shown to increase bone mass in mice. Because these agents are widely used therapeutically, it is possible that they may influence fracture epidemiology in humans, and they are a potential therapy for osteoporosis.

MATERIALS AND METHODS

We have studied the association of beta-blocker use with BMD and fracture rates in the Study of Osteoporotic Fractures. beta-blocker use was recorded at the fourth visit, in 8412 women, of whom 1099 were users, and these women were followed for 7 years.

RESULTS

Users had significantly higher weight, more thiazide use, more estrogen use, less glucocorticoid use, more statin use, and more hypertension than nonusers, and they smoked less. Total hip BMD at the fourth visit was higher in the beta-blocker users (0.746 versus 0.735 g/cm(2), p = 0.02), but adjustment for weight alone, or together with these other variables, eliminated this difference (p = 0.62). There was no effect of beta-blocker use on loss of hip BMD over a mean follow-up of 4 years (p = 0.48). Os calcis BMD at visit 4 was also higher in those taking beta-blockers (0.385 versus 0.375 g/cm(2), p = 0.005), but weight adjustment eliminated this difference (p = 0.14). The frequencies of hip or any fracture (since age 50) were similar in users and nonusers (p = 0.80 and p = 0.51, respectively). Over a mean follow-up of 7 years, there were 2167 total fractures, including 431 at the wrist and 585 at the hip. Among beta-blocker users, hazards ratios were 0.92 (0.81, 1.05) for any fracture, 0.74 (0.54, 1.01) for wrist fracture, and 0.76 (0.58, 0.99) for hip fracture. Adjustment for weight and other factors previously shown to influence hip fracture incidence in this cohort made little difference to the outcome. When fracture data were analyzed for nonselective and beta(1)-selective agents separately, trends toward fewer fractures were confined to the users of selective beta(1)-blockers.

CONCLUSIONS

beta-Blocker use and BMD are unrelated in this cohort, and associations with fracture risk are inconsistent. Therefore, a history of use of these drugs is not useful in assessing fracture risk, nor do they have a role in osteoporosis management at this time. The relationship between beta-blocker use and hip fracture deserves further study.

Authors+Show Affiliations

Department of Medicine, University of Auckland, Auckland, New Zealand. i.reid@auckland.ac.nzNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15765180

Citation

Reid, Ian R., et al. "Beta-Blocker Use, BMD, and Fractures in the Study of Osteoporotic Fractures." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 20, no. 4, 2005, pp. 613-8.
Reid IR, Gamble GD, Grey AB, et al. Beta-Blocker use, BMD, and fractures in the study of osteoporotic fractures. J Bone Miner Res. 2005;20(4):613-8.
Reid, I. R., Gamble, G. D., Grey, A. B., Black, D. M., Ensrud, K. E., Browner, W. S., & Bauer, D. C. (2005). Beta-Blocker use, BMD, and fractures in the study of osteoporotic fractures. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 20(4), 613-8.
Reid IR, et al. Beta-Blocker Use, BMD, and Fractures in the Study of Osteoporotic Fractures. J Bone Miner Res. 2005;20(4):613-8. PubMed PMID: 15765180.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - beta-Blocker use, BMD, and fractures in the study of osteoporotic fractures. AU - Reid,Ian R, AU - Gamble,Gregory D, AU - Grey,Andrew B, AU - Black,Dennis M, AU - Ensrud,Kristine E, AU - Browner,Warren S, AU - Bauer,Douglas C, Y1 - 2004/12/06/ PY - 2004/04/29/received PY - 2004/07/07/revised PY - 2004/10/22/accepted PY - 2005/3/15/pubmed PY - 2005/12/13/medline PY - 2005/3/15/entrez SP - 613 EP - 8 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 20 IS - 4 N2 - UNLABELLED: A role for osteoblastic beta-adrenoreceptors in bone regulation is suggested by the finding that beta-blockers increase bone mass in mice. We studied the association of beta-blocker use with BMD and fractures in the Study of Osteoporotic Fractures. beta-blocker use and BMD are unrelated in this cohort, and associations with fracture risk are inconsistent. INTRODUCTION: The central nervous system has been shown to regulate bone mass in mice, possibly by way of the beta(2)-adrenoreceptors on osteoblasts. beta-blockers have been shown to increase bone mass in mice. Because these agents are widely used therapeutically, it is possible that they may influence fracture epidemiology in humans, and they are a potential therapy for osteoporosis. MATERIALS AND METHODS: We have studied the association of beta-blocker use with BMD and fracture rates in the Study of Osteoporotic Fractures. beta-blocker use was recorded at the fourth visit, in 8412 women, of whom 1099 were users, and these women were followed for 7 years. RESULTS: Users had significantly higher weight, more thiazide use, more estrogen use, less glucocorticoid use, more statin use, and more hypertension than nonusers, and they smoked less. Total hip BMD at the fourth visit was higher in the beta-blocker users (0.746 versus 0.735 g/cm(2), p = 0.02), but adjustment for weight alone, or together with these other variables, eliminated this difference (p = 0.62). There was no effect of beta-blocker use on loss of hip BMD over a mean follow-up of 4 years (p = 0.48). Os calcis BMD at visit 4 was also higher in those taking beta-blockers (0.385 versus 0.375 g/cm(2), p = 0.005), but weight adjustment eliminated this difference (p = 0.14). The frequencies of hip or any fracture (since age 50) were similar in users and nonusers (p = 0.80 and p = 0.51, respectively). Over a mean follow-up of 7 years, there were 2167 total fractures, including 431 at the wrist and 585 at the hip. Among beta-blocker users, hazards ratios were 0.92 (0.81, 1.05) for any fracture, 0.74 (0.54, 1.01) for wrist fracture, and 0.76 (0.58, 0.99) for hip fracture. Adjustment for weight and other factors previously shown to influence hip fracture incidence in this cohort made little difference to the outcome. When fracture data were analyzed for nonselective and beta(1)-selective agents separately, trends toward fewer fractures were confined to the users of selective beta(1)-blockers. CONCLUSIONS: beta-Blocker use and BMD are unrelated in this cohort, and associations with fracture risk are inconsistent. Therefore, a history of use of these drugs is not useful in assessing fracture risk, nor do they have a role in osteoporosis management at this time. The relationship between beta-blocker use and hip fracture deserves further study. SN - 0884-0431 UR - https://www.unboundmedicine.com/medline/citation/15765180/beta_Blocker_use_BMD_and_fractures_in_the_study_of_osteoporotic_fractures_ L2 - https://doi.org/10.1359/JBMR.041202 DB - PRIME DP - Unbound Medicine ER -