RISK-FACTORS FOR HIP FRACTURE IN BLACK-WOMEN

Background. Although more than 1 percent of black women 80 years of ag e or older have hip fractures each year, little is known about risk fa ctors for hip fracture in these women. Methods. We carried out a case- control study involving 144 black women admitted with a first hip frac ture to 1 of 30 hospitals in New York and Philadelphia. The controls w ere 218 black women living in the community who were matched to the ca se patients according to age and ZIP Code or telephone exchange and 18 1 hospitalized black women matched according to age and hospital. Info rmation was obtained through personal interviews and was studied by mu ltivariable logistic-regression analysis. Results. When the case patie nts were compared with the control subjects from the community, the wo men in the lowest quintile for body-mass index had a markedly increase d risk of hip fracture as compared with the women in the highest quint ile (odds ratio, 13.5; 95 percent confidence interval, 4.2 to 43.3). P ostmenopausal estrogen therapy for one year or more was protective for women under 75 years of age (odds ratio, 0.1; 95 percent confidence i nterval, < 0.1 to 0.5). Factors associated with an increased risk of h ip fracture included a history of stroke (odds ratio, 3.1; 95 percent confidence interval, 1.2 to 8.1), use of aids in walking (odds ratio, 5.6; 95 percent confidence interval, 2.7 to 11.5), and consumption of seven or more alcoholic drinks per week (odds ratio, 4.6; 95 percent c onfidence interval, 1.5 to 14.1). The results were similar when the ca se patients were compared with the hospitalized control subjects. Conc lusions. Among black women thinness, previous stroke, use of aids in w alking, and alcohol consumption are associated with an increased risk of hip fracture. Postmenopausal estrogen therapy protects against hip fracture in women under 75 years of age.