Antihypertensive medicines and fracture threat: Is there an affiliation?
Additional examination of randomized scientific trial information means that thiazide diuretics to deal with hypertension could also be related to decrease danger of hip and pelvic fractures in contrast with another antihypertensive medicines, in keeping with an article printed on-line by JAMA Inside Drugs.
Joshua I. Barzilay, M.D., of Kaiser Permanente of Georgia, Atlanta, and coauthors examined the consequences of main lessons of blood pressure-lowering medicines on the incidence of hospitalization for hip and pelvic fractures.
The authors used Veterans Affairs and Medicare claims information together with information from the Antihypertensive and Lipid-Decreasing Therapy to Forestall Coronary heart Assault Trial (ALLHAT), a big examine that in contrast completely different antihypertensive therapies to stop deadly coronary coronary heart illness or nonfatal coronary heart assaults and different heart problems outcomes.
The examine reviews a 21 p.c decrease danger of hip and pelvic fractures related to the thiazide-type diuretic chlorthalidone in contrast with both lisinopril (an angiotensin-converting enzyme inhibitor) or amlodipine (a calcium channel blocker).
The analyses included 22,180 individuals adopted for as much as eight years and, after the trial was accomplished, 16,622 individuals had been adopted for as much as a further 5 years as a result of claims information had been obtainable for them. There have been 646 hip and pelvic fractures in trial plus put up trial follow-up.
In additional analyses that embody trial and post-trial follow-up, the fracture danger was decrease within the chlorthalidone group in contrast with the opposite remedy teams, though it was not statistically vital, in keeping with the outcomes. Through the post-trial interval, the examine protocol not constrained the selection of blood stress treatment.
The authors word a number of examine limitations together with that analyses had been carried out after the trial and that the current analyses relied on databases for fracture incidence reasonably than medical information.
"The current outcomes of short-term and long-term fracture safety with thiazide antihypertensive remedy in contrast with different antihypertensive medicines strongly suggest use of a thiazide for hypertension remedy along with its lengthy observe document of cardiovascular safety," the examine concludes.
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The authors used Veterans Affairs and Medicare claims information together with information from the Antihypertensive and Lipid-Decreasing Therapy to Forestall Coronary heart Assault Trial (ALLHAT), a big examine that in contrast completely different antihypertensive therapies to stop deadly coronary coronary heart illness or nonfatal coronary heart assaults and different heart problems outcomes.
The examine reviews a 21 p.c decrease danger of hip and pelvic fractures related to the thiazide-type diuretic chlorthalidone in contrast with both lisinopril (an angiotensin-converting enzyme inhibitor) or amlodipine (a calcium channel blocker).
The analyses included 22,180 individuals adopted for as much as eight years and, after the trial was accomplished, 16,622 individuals had been adopted for as much as a further 5 years as a result of claims information had been obtainable for them. There have been 646 hip and pelvic fractures in trial plus put up trial follow-up.
In additional analyses that embody trial and post-trial follow-up, the fracture danger was decrease within the chlorthalidone group in contrast with the opposite remedy teams, though it was not statistically vital, in keeping with the outcomes. Through the post-trial interval, the examine protocol not constrained the selection of blood stress treatment.
The authors word a number of examine limitations together with that analyses had been carried out after the trial and that the current analyses relied on databases for fracture incidence reasonably than medical information.
"The current outcomes of short-term and long-term fracture safety with thiazide antihypertensive remedy in contrast with different antihypertensive medicines strongly suggest use of a thiazide for hypertension remedy along with its lengthy observe document of cardiovascular safety," the examine concludes.
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