The relationship between antihypertensive drugs and risk of fracture - a longitudinal cohort study

• Main Authors: Hsueh-Fang Hung, 洪雪芳
• Other Authors: 陳鴻儀
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/du6p37

碩士 === 中國醫藥大學 === 藥學系碩士班 === 102 === Background Hypertension is a prevalent disease among the Taiwanese population. Approximately 25% of men, 18% of women, and 47% of the individuals over the age of 60 years have hypertension. Previous studies have shown that the lifetime prevalence rate of hypertension is approximately 90%. Moreover, the use of antihypertensives is associated with the onset of osteoporosis and bone fractures in patients. This study aims to explore the risk associated with common antihypertensive drugs in increasing the chances of a bone fracture in patients. Methods Data for this study were collected from the Taiwan National Healthcare Database using ICD-9CM to define the target disease; the data between 2002 and 2007 were collected. The inclusion criteria were as follows: at least two diagnoses of hypertension and use of antihypertensive medication at the time of enrollment. After collecting data about the basic demographic characteristics of the subjects, we examined the relationship between the type of antihypertensive medication and the risk of bone fracture by using Chi-square test and logistic regression analysis. Data were processed and analyzed using the SAS software. Results After selection, 32,569 subjects qualified for the study (47.4% women). During the observation period, 2,811 of them had bone fractures (67.16% women). After adjusting for gender, age, and comorbid diseases, the logistic regression analysis showed that thiazide diuretics and beta-blockers decreased the risk of a future bone fracture (thiazide diuretics OR, 0.85; 95% CI, 0.76-0.96 and beta-blockers OR, 0.85; 95% CI, 0.78-0.93), while loop diuretics increased the risk of bone fracture (OR, 1.50; 95% CI, 1.32-1.72). Conclusions The results of our study are consistent with those reported in previous studies. However, despite a low correlation between the use of antihypertensives and risk of bone fractures, the numbers cannot be ignored when a large population of antihypertensive users is taken into account. Therefore, physicians should be aware about the risk of bone fracture and should exercise caution when prescribing these medications.