The risk of hip fracture after initiating antihypertensive drugs in the elderly.

Notes: 

from: http://www.rheumatologynews.com/news/clinical-news/single-article/hip-fr...

Hypertensive elderly persons who began receiving an antihypertensive drug had a 43% increased risk of having a hip fracture during the first 45 days following treatment initiation relative to the control periodsThe risk of early fracture rose by 53% for patients started on an ACE inhibitor and by 58% for those on beta-blockers

TitleThe risk of hip fracture after initiating antihypertensive drugs in the elderly.
Publication TypeJournal Article
Year of Publication2012
AuthorsButt DA, Mamdani M, Austin PC, Tu K, Gomes T, Glazier RH
JournalArchives of internal medicine
Volume172
Issue22
Pagination1739-44
Date Published2012 Dec 10
ISSN1538-3679
KeywordsAged, Aged, 80 and over, Antihypertensive Agents, Female, Hip Fractures, Humans, Hypertension, Incidence, Male, Ontario, Population Surveillance, Retrospective Studies, Risk Factors
Abstract

BACKGROUND: Initiating antihypertensive drugs in the elderly has been associated with an immediate increased risk of falls. However, it is unknown whether initiation of antihypertensive drugs (eg, thiazide diuretics, angiotensin II converting-enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, or β-adrenergic blockers) is associated with an immediate increased risk of hip fractures.

METHODS: A population-based, self-controlled case series design using health care administrative databases identifying patients initiating an antihypertensive drug in Ontario, Canada. A cohort of newly treated hypertensive elderly patients was linked to the occurrence of hip fractures from April 1, 2000, to March 31, 2009, to create exposed cases. The risk period was the first 45 days following antihypertensive therapy initiation with control periods before and after treatment in a 450-day observation period. The outcome measure was the first occurrence for a proximal femoral fracture during the risk period. The analysis determined the relative incidence (incidence rate ratio), defined as the hip fracture rate in the risk period compared with control periods.

RESULTS: Among the 301,591 newly treated hypertensive community-dwelling elderly patients, 1463 hip fractures were identified during the observation period. Hypertensive elderly persons who began receiving an antihypertensive drug had a 43% increased risk of having a hip fracture during the first 45 days following treatment initiation relative to the control periods (incidence rate ratio, 1.43; 95% CI, 1.19-1.72).

CONCLUSIONS: Antihypertensive drugs were associated with an immediate increased hip fracture risk during the initiation of treatment in hypertensive community-dwelling elderly patients. Caution is advised when initiating antihypertensive drugs in the elderly.

DOI10.1001/2013.jamainternmed.469
Alternate JournalArch. Intern. Med.
PubMed ID23165923
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