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Loop Diuretic Use and Rates of Hip Bone Loss and Risk of Falls and Fractures in Older Women
Author(s) -
Lim Lionel S.,
Fink Howard A.,
Blackwell Terri,
Taylor Brent C.,
Ensrud Kristine E.
Publication year - 2009
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2009.02195.x
Subject(s) - medicine , hip fracture , confidence interval , diuretic , odds ratio , bone mineral , cohort study , relative risk , prospective cohort study , cohort , bone density , surgery , osteoporosis
OBJECTIVES: To determine whether loop diuretic use is associated with hip bone loss and greater risk of falls and fractures in older women. DESIGN: Prospective cohort study from August 1992 to April 2004. SETTING: Four regions in the United States from the Study of Osteoporotic Fractures (SOF). PARTICIPANTS: Women aged 65 and older (N=8,127) with medication use data who participated in the fourth SOF examination, from which three study cohorts were derived. MEASUREMENTS: Bone mineral density (BMD) of the total hip assessed using dual‐energy X‐ray absorptiometry at the fourth and sixth examinations (n=2,980); recurrent (≥2) falls in the year after the fourth examination (n=6,244); and incident fracture, including nonspine (n=6,778) and hip fracture (n=7,272). RESULTS: After multivariable adjustment, loop diuretic users had greater loss of total hip BMD than nonusers (mean annualized % BMD −0.87 vs −0.71, P =.03) after a mean of 4.4±0.6 years. The risks of recurrent falls (odds ratio=0.99, 95% confidence interval (CI)=0.71–1.39), nonspine (relative risk (RR)=1.04, 95% CI=0.90–1.21), and hip fracture (RR=1.03, 95% CI=0.81–1.31) were not greater in loop diuretic users than in nonusers. CONCLUSION: In this cohort of older women, loop diuretic use was associated with a small but significantly higher rate of hip bone loss than nonuse after a mean duration of 4.4 years, although the risk of falls or fracture did not differ between the two groups.