You are here

Article Text

Article menu

Download PDFPDF

XML
Cardiovascular medicine
Research
Danish register-based study on the association between specific cardiovascular drugs and fragility fractures
  1. Maia Torstensson1,
  2. Annette Højmann Hansen2,
  3. Katja Leth-Møller1,
  4. Terese Sara Høj Jørgensen1,
  5. Marie Sahlberg3,
  6. Charlotte Andersson4,
  7. Karl Emil Kristensen4,
  8. Jesper Ryg5,
  9. Peter Weeke6,
  10. Christian Torp-Pedersen7,
  11. Gunnar Gislason4,
  12. Ellen Holm1
  1. 1Department of Geriatric Medicine, Nykøbing Falster Hospital, Nykøbing Falster, Denmark
  2. 2Department of Internal Medicine, Slagelse Hospital, Slagelse, Denmark
  3. 3Department of Geriatric Medicine, Aalborg University Hospital, Aalborg, Denmark
  4. 4Department of Cardiology, Gentofte Hospital, Copenhagen, Denmark
  5. 5Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
  6. 6Department of Cardiology, Laboratory of Molecular Cardiology, Copenhagen University Hospital, Copenhagen, Denmark
  7. 7Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark
  1. Correspondence to Dr Ellen Holm; ellh{at}regionsjaelland.dk

Abstract

Objective To determine whether drugs used in treatment of cardiovascular diseases (CVD-drugs), including hypertension, increase the risk of fragility fractures in individuals above the age of 65 years.

Design Retrospective nationwide cohort study.

Setting Danish nationwide national registers.

Participants All individuals in Denmark ≥65 years who used specified CVD-drugs in the study period between 1999 and 2012.

Main outcomes measures Time-dependent exposure to CVD-drugs (nitrates, digoxin, thiazides, furosemide, ACE inhibitors, angiotensin receptor antagonists, β-blockers, calcium antagonists and statins) was determined by prescription claims from pharmacies. The association between use of specific CVD-drugs and fragility fractures was assessed using multivariable Poisson regression models, and adjusted incidence rate ratios (IRRs) were calculated.

Results Overall, 1 586 554 persons were included, of these 16.1% experienced a fall-related fracture. The multivariable Poisson regression analysis showed positive associations between fracture and treatment with furosemide, thiazide and digoxin. IRRs during the first 14 days of treatment were for furosemide IRR 1.74 (95% CI 1.61 to 1.89) and for thiazides IRR 1.41 (1.28 to 1.55); IRR during the first 30 days of treatment with digoxin was 1.18 (1.02 to 1.37).

Conclusions Use of furosemide, thiazides and digoxin was associated with elevated rates of fragility fractures among elderly individuals. This may warrant consideration when considering diuretic treatment of hypertension in elderly individuals.

  • accidental falls
  • fragility fractures
  • cardiovaslular drugs

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2015-009522

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text