In this paper we report the results on the epidemiology of hip fractur
e and the preventive efficacy of bone-active drugs in Italy, observed
in men and women aged 50 years or over, recruited in the three Italian
centres participating in the Mediterranean Osteoporosis Study (MEDOS)
, namely Parma, Rome, and Siena. The number of fractures observed was
1,437 in a catchment area population of 847,508 individuals, with a to
tal incidence of 169.6/100,000-a female-to-male ratio of 3.5 and a dou
bling-time of about 5.5 years. The female excess becomes evident in th
e age groups over 60 years. The mean age of fracture was 77 years in f
emales and 73 in males. From the data collected, the estimated number
of fractures per year in the Italian population aged over 50 years is
32,000. The pattern of use and the preventive efficacy of bone-active
drugs was examined in women. Calcitonin and calcium were the drugs mai
nly used; less than 3% had taken vitamin D or oestrogen and only a min
or percentage had taken anabolic steroids. Fluorides were not used at
all. As seen in the European sample, the protective effect of calcium
and calcitonin is statistically significant even in Italy, while vitam
in D is not. The use of anabolic steroids was associated with a decrea
se in risk. Oestrogen administration does not seem to reduce the relat
ive risk of hip fracture in Italian women, probably due to the small s
ample size.