Injuries. Thiazide diuretics and the risk of hip fracture among 70-79 year old women treated for hypertension

Abstract

A possible protective effect of thiazide diuretics against the risk of hip fracture was investigated in a case-control study among 70-79 year old women who had been continuously treated with anti-hypertensive drugs for at least 5 years. In 1992, 2 independent national random samples of general practitioners and internists from West Germany identified 311 cases, who had suffered from their first hip fracture in 1991 or 1992 and 414 controls without any fracture of the hip. Besides relevant information about personal characteristics and medical conditions, the physicians provided detailed documentation of all drug prescriptions between 1986 and 1992 using patient records. Odds ratios (adjusted ORs) with 95% confidence intervals (95% Cl) for the association between hip fracture and prescription of thiazides were adjusted for putative confounders such as age, body mass index, smoking habits, alcohol consumption and relevant medical conditions. For prescriptions of any thiazide diuretics for at least 2 consecutive quarters during the period 1986-1990 the adjusted odds ratio was 0.93 (95% Cl: 0.65-1.34). The OR was lower for drugs containing pure thiazides (adjusted OR = 0.74, 95% Cl: 0.33-1.67), but the risk reduction was not statistically significant. For drugs containing thiazides in combination with other agents the adjusted OR was 0.97 (95% Cl: 0.66-1.42). There was no significant association between the duration or cumulative doses of thiazide prescriptions and the risk of hip fracture. In conclusion, these data provide only little evidence, if any, of a protective effect of thiazide diuretics against the risk of hip fracture among 70-79 year old women treated for hypertension.