Citation

Lim LS, Fink HA, Blackwell T, Taylor BC, Ensrud KE. J. Am. Geriatr. Soc. 2009; 57(5): 855-862.

Copyright

(Copyright © 2009, John Wiley and Sons)

DOI

10.1111/j.1532-5415.2009.02195.x

PMID

unavailable

Abstract

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.