Effect of thiazide on rates of bone mineral loss: a longitudinal study
Abstract
OBJECTIVE: To determine the effect of thiazide diuretic drugs on rates of bone mineral loss.
DESIGN: Longitudinal, observational study with a mean follow up of five years.
SETTING: Hawaii Osteoporosis Center, Honolulu.
SUBJECTS: 1017 Japanese-American men born between 1900 and 1920, of whom 378 were treated for hypertension (study group) and 639 did not have hypertension (control group).
INTERVENTION: Thiazide diuretics were taken by 325 men for a mean of 11.9 years; 53 men took antihypertensive drugs other than thiazides.
MAIN OUTCOME MEASURE: Rate of bone loss estimated from serial photon absorptiometric scanning at three skeletal sites (calcaneus, distal radius, and proximal radius).
RESULTS: Rates of bone loss at all three sites were significantly reduced among thiazide users when compared with controls. The reductions in loss rate ranged from 28.8% (p = 0.02) (distal radius) to 49.2% (p = 0.0005) (calcaneus) relative to the controls. At all three sites the men taking other antihypertensive drugs had faster loss rates (22.6-43.1%) than those of the controls but the difference was significant only for the distal radius.
CONCLUSION: Thiazide diuretics slow the rate of bone loss in elderly men.
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 325 participants or records.
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