Antihypertensive drug classes and the risk of hip fracture: results from the Swedish primary care cardiovascular database.
Adrenergic beta-Antagonists
/ adverse effects
Angiotensin-Converting Enzyme Inhibitors
/ adverse effects
Antihypertensive Agents
/ adverse effects
Calcium Channel Blockers
/ adverse effects
Hip Fractures
/ chemically induced
Humans
Hypertension
/ complications
Primary Health Care
Risk Factors
Sweden
Journal
Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
pubmed:
1
10
2019
medline:
15
12
2020
entrez:
1
10
2019
Statut:
ppublish
Résumé
Hypertension and fractures related to osteoporosis are major public health problems that often coexist. This study examined the associations between exposure to different antihypertensive drug classes and the risk of hip fracture in hypertensive patients. We included 59 246 individuals, 50 years and older, diagnosed with hypertension during 2001-2008 in the Swedish Primary Care Cardiovascular Database. Patients were followed from 1 January 2006 (or the date of diagnosis of hypertension) until they had their first hip fracture, died, or reached the end of the study on 31 December 2012. Cox proportional hazards models were used to calculate the risk of hip fracture across types of antihypertensive medications, adjusted for age, sex, comorbidity, medications, and socioeconomic factors. In total, 2593 hip fractures occurred. Compared to nonusers, current use of bendroflumethiazide or hydrochlorothiazide was associated with a reduced risk of hip fracture (hazard ratio 0.86; 95% CI 0.75-0.98 and hazard ratio 0.84; 95% CI 0.74-0.96, respectively), as was use of fixed drug combinations containing a thiazide (hazard ratio 0.69; 95% CI 0.57-0.83). Current use of loop diuretics was associated with an increased risk of hip fracture (hazard ratio 1.23; 95% CI 1.11-1.35). No significant associations were found between the risk of hip fracture and current exposure to beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, aldosterone-receptor blockers or calcium channel blockers. In this large observational study of hypertensive patients, the risk of hip fracture differed across users of different antihypertensive drugs, results that could have practical implications when choosing antihypertensive drug therapy.
Identifiants
pubmed: 31568060
doi: 10.1097/HJH.0000000000002245
pii: 00004872-202001000-00024
doi:
Substances chimiques
Adrenergic beta-Antagonists
0
Angiotensin-Converting Enzyme Inhibitors
0
Antihypertensive Agents
0
Calcium Channel Blockers
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
167-175Commentaires et corrections
Type : CommentIn
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