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Thiazide Diuretics and the Risk of Hip FractureResults From the Framingham Study
David T. Felson, MD, MPH;
Dorith Sloutskis, MPH;
Jennifer J. Anderson, PhD;
John M. Anthony;
Douglas P. Kiel, MD, MPH
JAMA. 1991;265(3):370-373.
Abstract
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Thiazide diuretics may preserve bone mass and prevent elderly women's osteopenic fractures, but studies have not distinguished between thiazide preparations or examined former users. We performed a case-control study looking at thiazide use and subsequent hip fracture in postmenopausal female members of the Framingham Study cohort. Cases who had experienced a first hip fracture (n = 176) were compared with age-matched controls (n = 672). Results showed a modest protective effect of any recent thiazide use (not significant). However, recent pure thiazide users experienced significant protection against fracture (adjusted odds ratio, 0.31; 95% confidence interval, 0.11 to 0.88), whereas recent users of combination drugs containing thiazides experienced no protection (adjusted odds ratio, 1.16; 95% confidence interval, 0.44 to 3.05). Combination drugs generally contained only 25 mg of hydrochlorothiazide, suggesting that the small amount of thiazide was insufficient to preserve bone mass. Former thiazide users were not protected against fracture. In sum, recent pure thiazide use in women protects against hip fracture.
(JAMA. 1991;265:370-373)
Author Affiliations
From the Boston University Arthritis Center (Drs Felson and Anderson, Ms Sloutskis, and Mr Anthony), and the Departments of Medicine, Boston City Hospital and University Hospital, Boston, Mass (Dr Felson); and the Division of General Internal Medicine, Brown University Program in Medicine and Rhode Island Hospital, Providence, RI (Dr Kiel).
Footnotes
Reprint requests to Arthritis Center, A-203, Boston University School of Medicine, 80 E Concord St, Boston, MA 02118 (Dr Felson).
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