Diuretic drug use and the risk for hip fracture

Article Abstract:

Hip fracture among the elderly is a serious health problem; as many as one third of the women, and 17 percent of the men, who reach the age of 90 have sustained this injury. The mortality associated with hip fracture may be as high as 20 percent. Several studies have cited thiazide diuretics (a class of drugs to control water balance) as reducing the risk of hip fracture; these agents appear to increase bone density (hence, strength). Furosemide, another type of diuretic, promotes calcium excretion by the kidneys, and therefore may increase the risk of hip fracture. To learn more concerning the rate of hip fracture among users of these commonly prescribed drugs, a study was carried out using a large database from a group health cooperative. Patients 50 years old or older who had sustained hip fractures (cases) were compared with patients of the same age and sex who had never had this injury (controls). Of interest were patients' diuretic use, height, weight, menopausal status, general health, use of other medications, and related factors. Results showed that users of thiazide diuretics had a risk of hip fracture that was 1.5 times greater than that of patients who did not use these agents. For users of furosemide, the risk was increased by a factor of 3.9. These findings indicate that thiazide diuretics were not only ineffective in reducing the risk for hip fracture, but were actually associated with a slightly increased risk. This possible complication should be evaluated further. Additional research concerning the relationship between furosemide and hip fracture is also needed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Dosage and administration, Furosemide

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Thiazide diuretics and osteoporosis: time for a clinical trial?

Article Abstract:

Hip fracture in the elderly is a common and costly injury; the risk of its occurrence doubles every five to seven years after the age of 65. The most effective preventive approaches are thought to be those that prevent bone loss (bone mass in the thighbone decreases steadily in the elderly) or restore bone mass. Commonly used treatments to slow the rate of bone loss include replacement estrogens (drugs that slow the resorption of calcium from bone) and sodium fluoride. Diuretics of the thiazide group (prescribed to control blood pressure) cause reductions in the amount of calcium excreted in urine, and have been shown in many studies to protect against bone loss and fractures in the elderly. However, a study in the July 1, 1991 issue of the Annals of Internal Medicine found that patients who used thiazides had a 60 percent increased risk for hip fracture. Further research is needed to clarify the role of thiazide diuretics in preventing bone loss; in part, because the issue affects as many as 25 percent of people older than 65 who take these drugs, and in part, because thiazides may affect bone mass differently in people with normal blood pressure than in people with high blood pressure. Since few other drugs appear to reduce the rate of bone mass loss in the elderly, clinical trials are now in order for thiazide diuretics. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Osteoporosis, editorial

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Thiazide diuretics and hip fracture risk

Article Abstract:

A group of drugs called thiazide diuretics may lower an elderly person's risk of hip fracture, according to a study of 7,891 people 55 years old and older. Those who took a thiazide diuretic for one year or more had a 50% reduction in hip fractures. However, this benefit stopped when they stopped taking the drug.

Pharmaceutical Preparation Manufacturing, Pharmaceutical preparations, Renal Diuretic Preparations

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