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To the Editor: I was disappointed that, in the National Institutes of Health (NIH) Consensus Statement on osteoporosis,¹ no mention was made of data showing that thiazide diuretics prevent the disease. At usual antihypertensive doses, thiazides have been shown to preserve bone mineralization at the wrist, elbow, and heel,² and the hip and spine.³ More importantly, the incidence of hip fracture is reduced by 30% in those patients taking thiazides.^4-5

Thiazides are inexpensive and safe, but no great profits are made from their sales. Instead, physicians are bombarded with data about bisphosphonates, selective estrogen-receptor modulators, and calcitonin, which are under patent and are expensive. The studies on thiazides for the prevention of osteoporosis are equally compelling and deserve more attention.

Robert S. Bobrow, MD
Bay Shore, NY

1. NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy. Osteoporosis prevention, diagnosis, and therapy. JAMA. 2001;285:785-795. FREE FULL TEXT 2. Wasnich RD, Benfante RJ, Yano K, Heilburn L, Vogel JM. Thiazide effect on the mineral content of bone. N Engl J Med. 1983;309:344-346. ABSTRACT 3. LaCroix AZ, Ott SM, Ichikawa L, Scholes D, Barlow WE. Low-dose hydrochlorothiazide and preservation of bone mineral density in older adults: a randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2000;133:516-526. FREE FULL TEXT 4. LaCroix AZ, Wienpahl J, White LR, et al. Thiazide diuretic agents and the incidence of hip fracture. N Engl J Med. 1990;322:286-290. ABSTRACT 5. Felson DT, Sloutskis D, Anderson JJ, Anthony JM, Kiel DP. Thiazide diuretics and the risk of hip fracture: results from the Framingham Study. JAMA. 1991;265:370-373. FREE FULL TEXT

To the Editor: The recent NIH Consensus Statement on osteoporosis¹ acknowledges the risk of low bone mineral density for osteoporosis in all populations . . . [Full Text of this Article]

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Osteoporosis Prevention, Diagnosis, and Therapy
NIH Consensus Development Panel on Osteoporosis Prevention, Diagnosis, and Therapy
JAMA. 2001;285(6):785-795.
ABSTRACT | FULL TEXT