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Published on: August 17, 2017

Thiazide diuretics and the risk of hip fracture

Koko Aung1, Thwe Htay

  • 1Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, MC 7879, San Antonio, Texas, USA, 78229.

The Cochrane Database of Systematic Reviews
|October 7, 2011
PubMed

Insights

Thiazide diuretics, commonly used for high blood pressure, appear to reduce hip fracture risk. Further randomized controlled trials are needed to confirm this association and its clinical implications.

Area of Science:

  • Gerontology
  • Pharmacology
  • Epidemiology

Background:

  • Thiazide diuretics are widely prescribed antihypertensive medications.
  • Thiazides decrease urinary calcium excretion and are linked to increased bone mineral density.
  • Potential benefits of thiazides in preventing hip fractures are debated due to concerns about fall risk.

Purpose of the Study:

  • To evaluate the association between thiazide diuretic use and the incidence of hip fractures in adult populations.
  • To synthesize evidence from existing randomized controlled trials and observational studies.

Main Methods:

  • A comprehensive literature search was conducted across multiple databases up to December 2008.
  • Included studies were randomized controlled trials and observational studies (cohort and case-control) assessing thiazide use and hip fracture risk.
  • Data extraction and risk of bias assessment were performed independently by two reviewers.

Main Results:

  • No randomized controlled trials were identified; analysis included 21 observational studies with nearly 400,000 participants.
  • Meta-analysis of 5 unique cohort studies indicated thiazide use was associated with a 24% reduction in hip fracture risk (pooled RR 0.76).
  • High heterogeneity precluded a pooled analysis of case-control studies.

Conclusions:

  • Observational data suggest that thiazide diuretics may lower the risk of hip fracture.
  • Further high-quality randomized controlled trials are necessary to substantiate these findings and clarify clinical recommendations.
Abstract

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