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Long-term Effects of Antihypertensive Drug Use and New-onset Osteoporotic Fracture in Elderly Patients: A Population-based Longitudinal Cohort Study.
Chin Med J (Engl) 2016; 129(24):2907-2912CM

Abstract

BACKGROUND

Antihypertensive drugs have been linked to new-onset osteoporotic fracture (NOF), and different classes of antihypertensive drugs may alter the risk for the development of NOF; however, the classic effect of different antihypertensive drugs on the development of NOF in the elderly has not been well studied during long-term follow-up.

METHODS

In this study, we investigated the association between different classic antihypertensives and the development of NOF in the elderly. This was a longitudinal cohort study performed using data from claim forms submitted to the Taiwan Bureau of National Health Insurance in Central Taiwan, China including case patients with NOF aged 65-80 years from January 2002 to December 2012 and non-NOF controls. Prescriptions for antihypertensives before the index date were retrieved from a prescription database. We estimated the hazard ratios (HR s) of NOF associated with antihypertensive use. Non-NOF controls served as the reference group.

RESULTS

A total of 128 patients with NOF were identified from among 1144 patients with hypertension during the study period. The risk of NOF after adjusting age, sex, comorbidities, and concurrent medications was higher among the users of angiotensin-converting enzyme (ACE) inhibitors (HR, 1.64; 95% confidence interval [CI], 1.01-2.66) than among nonusers. Patients who took calcium channel blockers (CCBs) (HR, 0.70; 95% CI, 0.49-0.99) were at a lower risk of developing NOF than nonusers. Loop diuretics, thiazide diuretics, angiotensin receptor blocker, beta-blocker, and alpha-blocker were not associated with the risk of NOF.

CONCLUSIONS

Elderly with hypertension who take CCBs are at a lower risk of NOF and that the use of ACE inhibitors was associated with a significantly increased risk of developing NOF during the 11-year follow-up.

Authors+Show Affiliations

Institute of Pharmacy, China Medical University, Taichung, Taiwan 40402; Department of Pharmacy, China Medical University Beigang Hospital, Yunlin County, Taiwan 65152, China.Department of Endocrinology and Metabolism, Shangluo Central Hospital, Shangluo, Shaanxi 726000, China.Institute of Pharmacy, China Medical University, Taichung, Taiwan 40402, China.Department of Family Medicine and Geriatrics, School of Public Health, National Defense Medical Center, Taichung Veteran General Hospital, Taichung, Taiwan 40705, China.Division of Internal Cardiology, Chung Shan Medical University Hospital, Chung Shan Medical University, Taichung, Taiwan 40201; Department of Basic Science, Central Taiwan University of Science and Technology, Taichung, Taiwan 40601, China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27958221

Citation

Chen, Hung-Yi, et al. "Long-term Effects of Antihypertensive Drug Use and New-onset Osteoporotic Fracture in Elderly Patients: a Population-based Longitudinal Cohort Study." Chinese Medical Journal, vol. 129, no. 24, 2016, pp. 2907-2912.
Chen HY, Ma KY, Hsieh PL, et al. Long-term Effects of Antihypertensive Drug Use and New-onset Osteoporotic Fracture in Elderly Patients: A Population-based Longitudinal Cohort Study. Chin Med J. 2016;129(24):2907-2912.
Chen, H. Y., Ma, K. Y., Hsieh, P. L., Liou, Y. S., & Jong, G. P. (2016). Long-term Effects of Antihypertensive Drug Use and New-onset Osteoporotic Fracture in Elderly Patients: A Population-based Longitudinal Cohort Study. Chinese Medical Journal, 129(24), pp. 2907-2912. doi:10.4103/0366-6999.195472.
Chen HY, et al. Long-term Effects of Antihypertensive Drug Use and New-onset Osteoporotic Fracture in Elderly Patients: a Population-based Longitudinal Cohort Study. Chin Med J. 2016 12 20;129(24):2907-2912. PubMed PMID: 27958221.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term Effects of Antihypertensive Drug Use and New-onset Osteoporotic Fracture in Elderly Patients: A Population-based Longitudinal Cohort Study. AU - Chen,Hung-Yi, AU - Ma,Kai-Yan, AU - Hsieh,Pei-Ling, AU - Liou,Yi-Sheng, AU - Jong,Gwo-Ping, PY - 2016/12/14/entrez PY - 2016/12/14/pubmed PY - 2017/3/14/medline SP - 2907 EP - 2912 JF - Chinese medical journal JO - Chin. Med. J. VL - 129 IS - 24 N2 - BACKGROUND: Antihypertensive drugs have been linked to new-onset osteoporotic fracture (NOF), and different classes of antihypertensive drugs may alter the risk for the development of NOF; however, the classic effect of different antihypertensive drugs on the development of NOF in the elderly has not been well studied during long-term follow-up. METHODS: In this study, we investigated the association between different classic antihypertensives and the development of NOF in the elderly. This was a longitudinal cohort study performed using data from claim forms submitted to the Taiwan Bureau of National Health Insurance in Central Taiwan, China including case patients with NOF aged 65-80 years from January 2002 to December 2012 and non-NOF controls. Prescriptions for antihypertensives before the index date were retrieved from a prescription database. We estimated the hazard ratios (HR s) of NOF associated with antihypertensive use. Non-NOF controls served as the reference group. RESULTS: A total of 128 patients with NOF were identified from among 1144 patients with hypertension during the study period. The risk of NOF after adjusting age, sex, comorbidities, and concurrent medications was higher among the users of angiotensin-converting enzyme (ACE) inhibitors (HR, 1.64; 95% confidence interval [CI], 1.01-2.66) than among nonusers. Patients who took calcium channel blockers (CCBs) (HR, 0.70; 95% CI, 0.49-0.99) were at a lower risk of developing NOF than nonusers. Loop diuretics, thiazide diuretics, angiotensin receptor blocker, beta-blocker, and alpha-blocker were not associated with the risk of NOF. CONCLUSIONS: Elderly with hypertension who take CCBs are at a lower risk of NOF and that the use of ACE inhibitors was associated with a significantly increased risk of developing NOF during the 11-year follow-up. SN - 2542-5641 UR - https://www.unboundmedicine.com/medline/citation/27958221/Long_term_Effects_of_Antihypertensive_Drug_Use_and_New_onset_Osteoporotic_Fracture_in_Elderly_Patients:_A_Population_based_Longitudinal_Cohort_Study_ L2 - http://dx.doi.org/10.4103/0366-6999.195472 DB - PRIME DP - Unbound Medicine ER -