Effect of Antihypertensive Medications on Fracture Risk

A research study examined the effects of antihypertensive medications on the incidence of pelvic and hip fractures.

Thiazide diuretics used for the treatment of hypertension is found to be associated with lower risk of hip and pelvic fractures when compared with other antihypertensive medications.

The study findings were published online by JAMA Internal Medicine.

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‘Antihypertensive medicines like thiazide diuretics were found to lower the risk of hip and pelvic fractures.’

Joshua I. Barzilay, M.D., of Kaiser Permanente of Georgia, Atlanta, and coauthors examined the effects of major classes of blood pressure-lowering medications on the incidence of hospitalization for hip and pelvic fractures.

The authors used Veterans Affairs and Medicare claims data along with data from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT), a large study that compared different antihypertensive therapies to prevent fatal coronary heart disease or nonfatal heart attacks and other cardiovascular disease outcomes.

The study reports a 21 percent lower risk of hip and pelvic fractures associated with the thiazide-type diuretic chlorthalidone compared with either lisinopril (an angiotensin - converting enzyme inhibitor) or amlodipine (a calcium channel blocker).

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The analyses included 22,180 participants followed for up to eight years and, after the trial was completed, 16,622 participants were followed for up to an additional five years because claims data were available for them. There were 646 hip and pelvic fractures in trial plus post trial follow-up.

In further analyses that include trial and post-trial follow-up, the fracture risk was lower in the chlorthalidone group compared with the other treatment groups, although it was not statistically significant, according to the results. During the post-trial period, the study protocol no longer constrained the choice of blood pressure medication.

Quiz on Antihypertensive Drugs
If you are suffering from high blood pressure, it is very likely that you will be put on antihypertensive medications. Are you curious to find out why your doctor has chosen that particular medication for you, or what are its benefits or side effects? Test your knowledge on antihypertensives by taking this quiz.

There are 10 questions on antihypertensive drugs in this quiz that will explore the depth of your knowledge and provide answers to the following:

Complications of high blood pressure ()
Mechanism of action of hydrochlorothiazide ()
Side effects of spironolactone ()
Is it safe to take antihypertensives while pregnant? ()
Weight reduction associated with high blood pressure ()
Dietary instructions to follow ()

The authors note several study limitations including that analyses were conducted after the trial and that the present analyses relied on databases for fracture occurrence rather than medical records.

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More than three-quarters of the patients were observed to be exposed to one non-opiate drug associated with increased fracture risk in four months before the fracture.

"The present results of short-term and long-term fracture protection with thiazide antihypertensive therapy compared with other antihypertensive medications strongly recommend use of a thiazide for hypertension treatment in addition to its long track record of cardiovascular protection," the study concludes.

Source-Eurekalert