Thiazide diuretic agents and the incidence of hip fracture

Article Abstract:

Fractures of the hip caused more than three million hospitalization days in 1987 for Americans over the age of 65. In addition, these fractures cause loss of mobility, independence, and are responsible for many deaths in this aged population. Because of the financial cost and social consequence of this problem, a low-cost, safe method for reducing the incidence of hip fracture is a national priority. Thiazide is a commonly prescribed diuretic drug that is used to reduce blood pressure by causing the kidney to increase its excretion of salts and water. The drug has also been found to reduce the elimination of calcium, thereby increasing the retention of calcium within its deposits in bones. The present study examines the ability of thiazide to reduce the incidence of hip fractures within groups of elderly individuals living in Boston, New Haven, and Iowa. Volunteers over 65 were interviewed by a trained interviewer who collected demographic data and medical histories. The final study population included 9,518 individuals in the three locations. The interviews were used to identify individuals who were currently using thiazide, and annual follow-up interviews established the rate of hip fracture. At the initiation of the study, between 24 to 30 percent of individuals were taking thiazide for various other medical problems. During the course of the study 242 cases of hip fracture were reported, which represents an incidence of 5.43 percent for men and 9.96 percent for women. The incidence of hip fracture was lower in users of thiazide. Overall and in each of the three communities individuals who took thiazide experienced an approximate one-third reduction in the number of hip fractures. This study supports the use of thiazide as a preventive method for reducing the risk of hip fracture in older individuals. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aged, Elderly, Bones, Prevention, Wounds and injuries, Injuries, Osteoporosis, Fractures (Injuries), Fractures, Thiazides

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Smoking and mortality among older men and women in three communities

Article Abstract:

It is well established that smoking is a major risk factor for both heart disease and lung cancer in middle-aged people. However, four fifths of all deaths from heart disease occur in people over 65, as do two thirds of all cancer deaths. It is less certain that smoking exerts a significant health effect on this age group. The available evidence has been interpreted by some as suggesting that long-term smokers who survive middle age are at no more risk than nonsmokers. Others debate this suggestion. To resolve the question, a prospective study was begun on 7,178 people 65 or older who had no history of heart disease, stroke, or cancer. During the next five years, 1,442 of the subjects died; 729 of these deaths were the result of heart disease and 316 deaths were due to cancer. An analysis of the data indicated that the risk of premature death was roughly twice as great for the current smokers as for those who had never smoked. The relative risk of death from heart disease for men who smoked was 2.0 times the risk of men who never smoked, and the risk among women was 1.4 times that of women who never smoked. Similarly, the relative risk of death from cancer was 2.4 times as great in smokers than nonsmokers, for both women and men. The study also found that former smokers had approximately the same risks of heart disease and death as people who had never smoked. These results not only confirm that smoking is a significant health hazard even among older people, but also that quitting smoking significantly reduces this risk. (Consumer Summary produced by Reliance Medical Information, Inc.)

Patient outcomes, Mortality, Smokers, Smoking, Cigarettes, Tobacco habit

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Calcium plus vitamin D supplementation and the risk of fractures

Article Abstract:

The efficacy of calcium with vitamin D supplementation for preventing hip and other fractures in healthy` postmenopausal women is examined. Amongst the healthy postmenopausal women, calcium with vitamin D supplementation resulted in a small but significant improvement in hip bone density, did not significantly reduce hip fracture and increased risk of kidney stones.

United States, Pharmaceutical Preparation Manufacturing, All Other Basic Inorganic Chemical Manufacturing, Pharmaceutical preparations, Industrial inorganic chemicals, not elsewhere classified, Calcium, Calcium Supplements, Usage, Vitamin D, Calcium (Nutrient), Calcium, Dietary, Alfacalcidol, Calcifediol

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