Diuretic Use and Risk of Vertebral Fracture in Women
Autor: | Harold N. Rosen, Gary C. Curhan, Julie M. Paik, Catherine M. Gordon |
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Rok vydání: | 2016 |
Předmět: |
Risk
medicine.medical_specialty medicine.drug_class Sodium Chloride Symporter Inhibitors medicine.medical_treatment Osteoporosis 030209 endocrinology & metabolism Comorbidity 03 medical and health sciences 0302 clinical medicine Sodium Potassium Chloride Symporter Inhibitors Bone Density medicine Humans Prospective Studies 030212 general & internal medicine Thiazide Proportional Hazards Models Bone mineral business.industry General Medicine Middle Aged Loop diuretic medicine.disease Health Surveys Surgery Hypertension Multivariate Analysis Spinal Fractures Calcium Female Nurses' Health Study Self Report Diuretic business Hyponatremia Risk assessment medicine.drug |
Zdroj: | The American Journal of Medicine. 129:1299-1306 |
ISSN: | 0002-9343 |
Popis: | Vertebral fracture is the most common type of osteoporotic fracture. While thiazide diuretics, which are commonly prescribed for the treatment of hypertension, decrease calciuria, they may also induce hyponatremia, which has been associated with increased vertebral fracture risk. Loop diuretics increase calciuria, which would reduce bone mineral density and increase vertebral fracture risk, but they rarely cause hyponatremia. Recent studies on diuretics and fractures did not include or specifically examine vertebral fracture. The few studies of diuretics and vertebral fracture have been limited by cases defined by self-report or administrative data, relatively small number of cases, study design that was not prospective, and lack of long-term follow-up with updated information on diuretic use.We conducted a prospective cohort study of thiazide diuretic use, loop diuretic use, and risk of incident clinical vertebral fracture in 55,780 women, 55-82 years of age, participating in the Nurses' Health Study, without a prior history of any fracture. Diuretic use was assessed by questionnaire every 4 years. Self-reported vertebral fracture was confirmed by medical record review. Cox proportional-hazards models were used to simultaneously adjust for potential confounders.Our analysis included 420 incident vertebral fracture cases documented between 2002 and 2012. The multivariate-adjusted relative risk of clinical vertebral fracture for women taking thiazides compared with women not taking thiazides was 1.47 (95% confidence interval, 1.18-1.85). The multivariate adjusted relative risk of vertebral fracture for women taking loop diuretics compared with women not taking loop diuretics was 1.59 (95% confidence interval, 1.12-2.25).Thiazide diuretics and loop diuretics are each independently associated with increased risk of vertebral fracture in women. |
Databáze: | OpenAIRE |
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