Thiazides and bone mineral density in elderly men and women

The relation of bone mineral density of the ultradistal radius, midshaft radius, hip, and lumbar spine to thiazide use were examined in a community-based sample of 1,696 white men and women aged 44-98 years. Male thiazide users had higher age-adjusted bone mineral density levels only at the midshaft radius (p < 0.05). Among women, thiazide users had significantly higher bone mineral density levels at all four sites (p < 0.05), both before and after controlling for the effects of age, body mass index, smoking, and estrogen use. The association was explained by current thiazide use; no significant association was found between past use or duration of use and bone mineral density levels. Results were similar when hypertensive women were excluded from the analyses, suggesting the effect was drug-related and not due to hypertension or some other factor related to hypertension. At all sites, the highest bone mineral density levels were seen in women currently using both estrogen and thiazide. Overall, these findings suggest that thiazides may be useful in the prevention of osteoporosis in postmenopausal women.