Can thiazides also reduce the risk of bone fractures in hypertensive patients?

This aim of this study was to investigate if thiazide treatment can reduce the risk of bone fractures in hypertensive patients with osteoporosis. The authors concluded that thiazides can reduce the risk of bone fractures, especially with longer treatment duration.

Osteoporosis is a skeletal disease that can weaken the bones and increase the risk of fractures. Older age, menopause, and lifestyle factors such as smoking and inactivity are all risk factors for both osteoporosis and hypertension. 

Thiazides are a type of treatment often prescribed for hypertension. They are a type of diuretic drug that cause the body to produce more urine and urinate more frequently. This reduces the blood pressure by reducing the amount of fluid in the body. They are also thought to help prevent bone mineral loss and osteoporosis. Thiazides could therefore be a valuable long-term treatment for hypertensive patients at high risk of osteoporosis and fractures.

The records of 57,822 patients with hypertension were included in analysis. The effect of thiazide use on the risk of osteoporotic bone fractures was examined. Patients were followed for up to 6 years.

Patients using thiazides were 11% less likely to sustain a bone fracture compared to patients who have never used thiazides. Patients who had longer treatment times with thiazides were 13% less likely to sustain a bone fracture. Discontinuation of thiazide increased the risk of bone fracture by 18%.

Thiazide treatment decreased the risk of bone fractures in both men and women. However, the results were statistically significant for men but not for women. In men, the risk of bone fractures increased after a long duration since the last thiazide treatment (more than 6 months). In women, the risk increased after only a short duration since the last treatment period (4 months).

The authors concluded that thiazide treatment can lead to a decreased risk of bone fractures in hypertensive patients. Discontinuation of thiazide treatment can increase the risk of bone fractures. 

Patient data for blood pressure, smoking status, and body mass index was collected at the start of the study but was not updated throughout. These factors may also affect the risk associated with bone fractures.