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Related Concept Videos

Antihypertensive Drugs: Thiazide-Class Diuretics01:15

Antihypertensive Drugs: Thiazide-Class Diuretics

917
Thiazide diuretics are sulfonamide derivatives featuring a benzothiadiazine ring system in their molecular structure. Based on this structure, thiazide diuretics can be categorized into two groups: thiazide-type and thiazide-like diuretics. Thiazide-type diuretics, including hydrochlorothiazide and chlorothiazide, consist of a benzothiadiazine backbone with an attached sulfonamide group. Thiazide-like diuretics, such as chlorthalidone and indapamide, lack the thiazide ring but demonstrate...
917

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Thiazide use and skeletal microstructure: Results from a multi-ethnic study.

Hoang-Long Huynh1, Lena Fan1, Carmen Germosen1

  • 1Division of Endocrinology, Columbia University Irving Medical Center, New York, NY 10032, United States of America.

Bone Reports
|May 23, 2022
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Summary

Thiazide diuretics may benefit bone health in women, modestly increasing bone mineral density at the radius. This suggests potential skeletal advantages for women using thiazides for conditions like hypertension.

Keywords:
FractureMicrostructureStiffnessThiazide

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Area of Science:

  • Bone biology and pharmacology
  • Geriatric medicine
  • Cardiovascular health

Background:

  • Thiazide diuretics are commonly prescribed antihypertensives.
  • Previous studies suggest thiazides increase areal bone mineral density (aBMD).
  • Conflicting data exist on thiazide effects on fracture risk, with no information on skeletal microstructure or mechanical competence.

Purpose of the Study:

  • To compare skeletal microstructure, volumetric BMD (vBMD), stiffness, and prevalent fractures in elderly thiazide users versus non-users.
  • To investigate the skeletal effects of thiazide diuretics in a multiethnic cohort of adults aged 65 years and older.

Main Methods:

  • Utilized a population-based, multiethnic cohort of 599 adults aged ≥65 years.
  • Employed high-resolution peripheral quantitative computed tomography (HR-pQCT) and micro-finite element analysis.
  • Compared current thiazide diuretic users with non-users, adjusting for covariates.

Main Results:

  • In women, thiazide use was associated with a 3.2% higher mean aBMD at the 1/3 radius (p=0.03) and a 2.4% higher cortical vBMD at the radius (p=0.03).
  • No significant differences in stiffness or skeletal parameters were observed in males.
  • DXA results were consistent in Black females, but no differences in stiffness were found in any group.

Conclusions:

  • Thiazide use is linked to modestly higher aBMD and radial cortical vBMD in women.
  • These findings suggest potential skeletal benefits of thiazides for women with conditions like hypertension or recurrent kidney stones.
  • Further research may elucidate the precise mechanisms and long-term skeletal implications of thiazide use.