SAN DIEGO – The risk of hip fracture nearly doubles in the week following a new prescription for a loop diuretic.
In contrast, there is no spike in the risk of hip fracture in the 7 days after a new prescription for other classes of diuretics or for ACE inhibitors, according to an analysis of the Health Improvement Network (THIN) database involving more than 400 U.K. primary care practices.
The short-term jump in risk of hip fracture may be related to the prominent urinary symptoms that often accompany a new prescription for loop diuretics. The resultant rush to the bathroom could increase falls during that initial adjustment period, Dr. Sarah D. Berry speculated.
She reported on 28,703 subjects who experienced a hip fracture and more than 2 million others who did not. She and her coworkers compared the occurrence of new diuretic prescriptions in the 7 days prior to a hip fracture to the occurrence of new diuretic prescriptions in the control period 31–37 days before the fracture.
The adjusted odds ratio of an incident hip fracture was significantly increased by 80% in the 7 days following a new prescription for a loop diuretic. The absolute risk during this week-long window, however, remained low: 2.9 hip fractures per 100,000 new loop diuretic prescriptions, said Dr. Berry of the Hebrew SeniorLife Institute for Aging Research and Beth Israel Deaconess Medical Center, Boston.
Dr. Berry declared having no financial conflicts regarding the study, which was supported by the National Institutes of Health and Hebrew SeniorLife.