The effect of treatment with a thiazide diuretic for 4 years on bone density in normal postmenopausal women

Bolland, Mark J; Ames, Ruth; Horne, Anne; Orr-Walker, Brandon; Gamble, Greg; Reid, Ian R.

doi:10.1007/s00198-006-0259-y

Cited by 115 publications

(67 citation statements)

References 30 publications

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“…They demonstrated that thiazid diuretics altered the intracellular calcium regulation in rat osteoblastlike cells, thus providing evidence of direct effects of thiazid diuretics on bone cells. In RCTs, thiazid diuretics have been associated with a modest positive effect on bone mineral density at the hip , Bolland et al, 2007, Reid et al, 2000. In accordance with these studies, thiazid diuretic use has been associated with reduced hip fracture rates as reported in observational studies (Reid et al, 2000, Bolland et al, 2007, Rejnmark et al, 2005b, Herings et al, 1996, Schoofs et al, 2003.…”

Section: Thiazid Diuretic Usesupporting

confidence: 64%

“…In RCTs, thiazid diuretics have been associated with a modest positive effect on bone mineral density at the hip , Bolland et al, 2007, Reid et al, 2000. In accordance with these studies, thiazid diuretic use has been associated with reduced hip fracture rates as reported in observational studies (Reid et al, 2000, Bolland et al, 2007, Rejnmark et al, 2005b, Herings et al, 1996, Schoofs et al, 2003. However, these potential positive effects of thiazid diuretics on bone health were modest and therefore a long-term treatment period may be needed to improve implant fixation and thereby reduce the risk of revision.…”

Section: Thiazid Diuretic Usementioning

confidence: 60%

“…However, only a modest effect on bone mineral density was reported and that is after more than 2 years of thiazid treatment (Bolland et al, 2007, Reid et al, 2000. This finding was confirmed in a observational study that reported an increased bone mineral density in 70 year old women (Sigurdsson and Franzson, 2001).…”

Section: Thiazid Diureticsmentioning

confidence: 80%

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Use of medications and risk of revision after primary total hip arthroplasty

Thillemann¹

2009

Acta Orthopaedica

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Section: Thiazid Diuretic Usesupporting

confidence: 64%

Section: Thiazid Diuretic Usementioning

confidence: 60%

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Use of medications and risk of revision after primary total hip arthroplasty

Thillemann¹

2009

Acta Orthopaedica

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“…11,[20][21][22] These findings might be partly explained by the threefold increased risk of women to develop ACE-inhibitor-related cough or potential beneficial effects of thiazides on bone density in postmenopausal women. 23,24 Furthermore, safety concerns in prescribing ACEs to women of childbearing age might have contributed to the lower number of ACE-inhibitor prescriptions. However, only a small proportion of women aging 18-40 years were included (2.5%), and about two-thirds of women were 460 years old.…”

Section: Discussionmentioning

confidence: 99%

Antihypertensive drug therapy and blood pressure control in men and women: an international perspective

et al. 2009

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Cardiovascular death represents the single largest cause of mortality in women with 70% of deaths attributable to modifiable risk factors, such as hypertension. This analysis aims at evaluating, whether there are gender disparities in antihypertensive drug usage and blood pressure (BP) control. We included 18 017 patients with arterial hypertension from the International Survey Evaluating Microalbuminuria Routinely by Cardiologists in patients with Hypertension (I-SEARCH). The study was conducted between September 2005 and March 2006 in 26 countries, and data on patient demographics, cardiovascular disease and risk factors, BP, and cardiovascular drug treatment were collected. Mean systolic blood pressure (SBP) was 2.1 mm Hg higher in women (150.6 ± 0.35 mm Hg, n ¼ 8357/18 017) than in men (148.5 ± 0.35 mm Hg; Po0.0001, n ¼ 9526/18 017), whereas no difference in diastolic BP was seen (88.2 ± 0.20 vs 88±0.20 mm Hg; P ¼ 0.198). Gender differences in SBP were more pronounced in diabetic as compared with nondiabetic patients (3.5 vs 1.7 mm Hg, n ¼ 4272 vs n ¼ 13 611; Po0.0001) and became evident at an age 55 years old. Overall BP-control rate was 33.6% in men and 30.6% in women (Po0.0001) and was lower in diabetic as compared with non-diabetic patients. In all, 30% of patients used one, 40% used two and 30% used X3 drugs without gender differences. Response rates to different drug regimens appeared to be similar. However, women received more frequently thiazides and b-blockers, and less frequently ACE-inhibitors as monotherapy. Major efforts are required to improve BP-management, especially in women.

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“…Use of calcium supplements [31,32] and health status [33] (excellent/very good/good/fair/poor), were also included. Additionally, the use of estrogen [34] and other medications known to modify bone mineral density or fracture risk (statins [35], loop diuretics [36], thiazides [37], thyroid hormones [38]), and corticosteroids [39]) were included. Participants who were using bisphosphonates or selective estrogen receptor modulators (SERMs) were excluded.…”

Section: Covariatesmentioning

confidence: 99%

Soluble CD14 and fracture risk

et al. 2015

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Summary Soluble CD14 (sCD14) is an inflammatory marker associated with osteoclasts. Using Cox proportional hazards models, we found a positive association between plasma levels of sCD14 and risk of incident fracture among participants in the Cardiovascular Health Study. sCD14 may be useful in identifying those at risk for fracture. Introduction Soluble CD14, a proinflammatory cytokine, is primarily derived from macrophages/monocytes that can differentiate into osteoclasts. The purpose of this study was to examine the relationship between sCD14 levels and osteoporotic fractures. Methods In the Cardiovascular Health Study, 5462 men and women had sCD14 levels measured at baseline. Incident hip fractures (median follow-up time 12.5 years) and incident composite fractures (defined as the first hip, pelvis, humerus, or distal radius fracture, median follow-up 8.6 years) were identified from hospital discharge summaries and/or Medicare claims data. Cox proportional hazards models were used to model the association between sCD14 levels and time to incident hip or composite fracture, overall and as a function of race and gender.Results In unadjusted models, there was a positive association between sCD14 levels (per 1 standard deviation increase, i.e., 361.6 ng/mL) and incident hip (HR, 1.26; 95 % CI, 1.17, 1.36) and composite (HR, 1.20; 95 % CI, 1.12, 1.28) fractures. When models were fully adjusted for demographics, lifestyle factors, and medication use, these associations were no longer significant. However, in whites, the association of sCD14 levels with hip fractures remained significant in fully adjusted models (HR, 1.11; 95 % CI, 1.01-1.23). Associations of sCD14 levels with hip and composite fracture did not differ between men and women. Conclusions In this large cohort of community-dwelling older adults, higher sCD14 levels were associated with an increased risk of incident hip fractures in whites.

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The effect of treatment with a thiazide diuretic for 4 years on bone density in normal postmenopausal women

Abstract: Hydrochlorothiazide produces small positive benefits on cortical bone density that are sustained for at least the first 4 years of treatment. They provide a further option in the prevention of postmenopausal bone loss, especially for women with hypertension or a history of kidney stones.

Cited by 115 publications

References 30 publications

Use of medications and risk of revision after primary total hip arthroplasty

Use of medications and risk of revision after primary total hip arthroplasty

Antihypertensive drug therapy and blood pressure control in men and women: an international perspective

Soluble CD14 and fracture risk

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