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Danish register-based study on the association between specific cardiovascular drugs and fragility fractures

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. PAR...

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Autores principales: Torstensson, Maia, Hansen, Annette Højmann, Leth-Møller, Katja, Jørgensen, Terese Sara Høj, Sahlberg, Marie, Andersson, Charlotte, Kristensen, Karl Emil, Ryg, Jesper, Weeke, Peter, Torp-Pedersen, Christian, Gislason, Gunnar, Holm, Ellen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710826/
https://www.ncbi.nlm.nih.gov/pubmed/26715481
http://dx.doi.org/10.1136/bmjopen-2015-009522
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author Torstensson, Maia
Hansen, Annette Højmann
Leth-Møller, Katja
Jørgensen, Terese Sara Høj
Sahlberg, Marie
Andersson, Charlotte
Kristensen, Karl Emil
Ryg, Jesper
Weeke, Peter
Torp-Pedersen, Christian
Gislason, Gunnar
Holm, Ellen
author_facet Torstensson, Maia
Hansen, Annette Højmann
Leth-Møller, Katja
Jørgensen, Terese Sara Høj
Sahlberg, Marie
Andersson, Charlotte
Kristensen, Karl Emil
Ryg, Jesper
Weeke, Peter
Torp-Pedersen, Christian
Gislason, Gunnar
Holm, Ellen
author_sort Torstensson, Maia
collection PubMed
description 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.
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spelling pubmed-47108262016-01-28 Danish register-based study on the association between specific cardiovascular drugs and fragility fractures Torstensson, Maia Hansen, Annette Højmann Leth-Møller, Katja Jørgensen, Terese Sara Høj Sahlberg, Marie Andersson, Charlotte Kristensen, Karl Emil Ryg, Jesper Weeke, Peter Torp-Pedersen, Christian Gislason, Gunnar Holm, Ellen BMJ Open Cardiovascular Medicine 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. BMJ Publishing Group 2015-12-24 /pmc/articles/PMC4710826/ /pubmed/26715481 http://dx.doi.org/10.1136/bmjopen-2015-009522 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ 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/
spellingShingle Cardiovascular Medicine
Torstensson, Maia
Hansen, Annette Højmann
Leth-Møller, Katja
Jørgensen, Terese Sara Høj
Sahlberg, Marie
Andersson, Charlotte
Kristensen, Karl Emil
Ryg, Jesper
Weeke, Peter
Torp-Pedersen, Christian
Gislason, Gunnar
Holm, Ellen
Danish register-based study on the association between specific cardiovascular drugs and fragility fractures
title Danish register-based study on the association between specific cardiovascular drugs and fragility fractures
title_full Danish register-based study on the association between specific cardiovascular drugs and fragility fractures
title_fullStr Danish register-based study on the association between specific cardiovascular drugs and fragility fractures
title_full_unstemmed Danish register-based study on the association between specific cardiovascular drugs and fragility fractures
title_short Danish register-based study on the association between specific cardiovascular drugs and fragility fractures
title_sort danish register-based study on the association between specific cardiovascular drugs and fragility fractures
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710826/
https://www.ncbi.nlm.nih.gov/pubmed/26715481
http://dx.doi.org/10.1136/bmjopen-2015-009522
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