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Use of α‐blockers and the risk of hip/femur fractures
Author(s) -
Souverein P. C.,
Van Staa T. P.,
Egberts A. C. G.,
De la Rosette J. J. M. C. H.,
Cooper C.,
Leufkens H. G. M.
Publication year - 2003
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.2003.01227.x
Subject(s) - medicine , alfuzosin , hip fracture , odds ratio , doxazosin , femur , terazosin , tamsulosin , confidence interval , femur fracture , alendronic acid , osteoporosis , surgery , bisphosphonate , hyperplasia , prostate , lower urinary tract symptoms , cancer , blood pressure
Abstract. Objective. To study the association between use of α ‐blockers and risk of hip/femur fractures. Design. Population‐based case–control study. Setting. General Practice Research Database. Subjects. Cases were defined as men, aged 40 years and older with a first diagnosis for hip/femur fracture. Controls were matched 1 : 1 on gender, year of birth and general practitioner‐practice. Results. In all, 4571 cases and an equal number of controls were identified. Current use of α ‐blockers (prazosin, doxazosin, indoramin, terazosin, alfuzosin and tamsulosin) was compared with non‐use of α ‐blockers. Current use of α ‐blockers on the index date was associated with an increased risk of hip/femur fracture [adjusted odds ratio (OR) 1.9, 95% confidence interval (CI): 1.1–3.0] in the overall analysis. The effect was particularly strong for first prescriptions within a treatment episode (adjusted OR 5.1, 95% CI: 1.0–31.7) and during the first month of treatment (adjusted OR 4.1, 95% CI: 0.7–23.9). Stratification according to indication of use showed that current use of α ‐blockers was not associated with hip/femur fracture in men with a diagnosis of benign prostatic hyperplasia (adjusted OR 1.0, 95% CI: 0.4–2.5), but was associated in men who used α ‐blockers for cardiovascular disease (adjusted OR 2.8, 95% CI: 1.4–5.4). Conclusion. Current use of α ‐blockers was associated with an increased risk of hip/femur fracture and with the start of a new treatment episode. The effect seemed to be confined to patients who used α ‐blockers for cardiovascular disease. Caution with respect to first‐dose effects related to the initiation of a new episode of α ‐blocker treatment is advised.