A PROSPECTIVE-STUDY OF THIAZIDE USE AND FRACTURES IN WOMEN

Thiazide diuretics reduce urinary calcium and may inhibit bone resorpt ion, and hence may help to attenuate age-related bone loss and to lowe r the risk of osteoporotic fracture. We followed 83 728 women, who wer e 36-61 years of age at baseline in 1982, for 10 years with biennial m ailed questionnaires on which they reported incident fractures, use of thiazide diuretics, and other medical behavioral information. From de scriptions of fracture sites and circumstances, 251 hip (proximal femu r) and 1594 forearm (distal radius) fractures were identified as low o r moderate trauma events. After controlling for age, body mass index, menopausal status, postmenopausal hormone use, cigarette smoking and d ietary factors, we observed a statistically significant 22% reduction in the risk of forearm fractures among current thiazide users compared with women who reported no thiazide use. Risk appeared to decline wit h longer duration of use, reaching a 37% reduction in risk among women who had been using thiazides for 8 or more years. For hip fractures, thiazide use was protective among the postmenopausal women (relative r isk = 0.69, 95% confidence interval 0.48-0.99). We conclude that the p otential benefit of thiazide diuretics for osteoporosis should be cons idered when prescribing antihypertensive treatment.