SynthesisOsteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA2014
β-Adrenergic receptor antagonists and fracture risk: a meta-analysis of selectivity, gender, and site-specific effects.
Synthesis in Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 3 syntheses or guidelines pooled it, 71 citations in OpenAlex.
- Association of β-adrenergic receptor blockers use with the risk of fracture in adults: a systematic review and meta-analysis.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2025Pooled it
- A Systematic Review and Meta-Analyses of the Association Between Anti-Hypertensive Classes and the Risk of Falls Among Older Adults.Drugs & aging · 2018Pooled it
- Association of polymorphisms in the beta-2 adrenergic receptor gene with fracture risk and bone mineral density.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2015Pooled it
- Pharmacogenetic and microRNA mechanisms of beta blocker use on bone.Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research · 2025Trial
- Sympathetic β1-adrenergic signaling contributes to regulation of human bone metabolism.The Journal of clinical investigation · 2018Trial
- Clonidine increases bone resorption in humans.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2016Trial
- Osteoporosis and Skeletal Fragility in non-Metastatic Pheochromocytomas and Paragangliomas: The Adrenergic-Skeletal Axis.Calcified tissue international · 2026Review
- Tumor Radiotherapy-Induced Sympathetic Hyperactivation Orchestrates Rapid Systemic Bone Loss.Calcified tissue international · 2026Article
- Disuse Bone Loss After Spinal Cord Injury: Scope and Challenges, Potential Mechanisms, Treatment, and Future Directions.Journal of the Endocrine Society · 2026Review
- Sympathetic regulation of bone homeostasis and remodeling: molecular mechanisms, pathophysiological roles, and therapeutic implications.Frontiers in immunology · 2026Review
- Imbalances in adrenal hormones and their effects on bone metabolism.Endocrine journal · 2025Review
- Review
- The autonomic nervous system and bone health in chronic kidney disease.European journal of clinical investigation · 2025Review
- Autonomic Nervous System Dysregulation and Bone Health in Patients with CKD: Potential for Intervention.Clinical journal of the American Society of Nephrology : CJASN · 2025Article
- Bone metastases in pheochromocytomas and paragangliomas: a narrative review of presentation, diagnosis and management.Frontiers in endocrinology · 2025Review
- Association of RAAS inhibitors on osteoporosis and fracture risk in the hypertensive population-A prospective population-based cohort study in Lanzhou, China.BMC musculoskeletal disorders · 2024Article
- Protective Effects of β-Blockers on Bone in Older Adults with Dementia.Calcified tissue international · 2024Article
- Crosstalk between Lipid Metabolism and Bone Homeostasis: Exploring Intricate Signaling Relationships.Research (Washington, D.C.) · 2024Article
- Evidence in Humans for Bone as an Endocrine Organ Regulating Energy Metabolism.Current opinion in endocrine and metabolic research · 2023Article
- The Association of Beta-Blocker Use and Bone Mineral Density Level in Hemodialysis Patients: A Cross-Sectional Study.Medicina (Kaunas, Lithuania) · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
unlabelledBy meta-analysis, the risk of fracture was 15% lower in patients treated with β-adrenergic blockers compared to controls independent of gender, fracture site, and dose. This might be attributable to β1-selective blockers.
introductionThe aim of this study is to determine by meta-analysis whether β-adrenergic blockers (BBs) reduce fracture risk and whether the effect, if demonstrable, is dependent upon selectivity, dose, gender, or fracture site.
methodsA literature search was performed in electronic databases MEDLINE, EMBASE, and reference sections of relevant articles to identify eligible studies. Adjusted estimates of fracture risk effect size (ES) were pooled across studies using fixed or random-effects (RE) meta-analysis as appropriate. Dose-related effects were evaluated using meta-regression. To explore the relative efficacy of β1-selective blockers in comparison to nonselective BBs, adjusted indirect comparison was performed.
resultsA total of 16 studies (7 cohort and 9 case-control studies), involving 1,644,570 subjects, were identified. The risk of any fracture was found to be significantly reduced in subjects receiving BBs as compared to control subjects (16 studies, RE pooled ES = 0.86, 95% CI 0.78-0.93; I(2) = 87 %). In a sensitivity analysis limited to those studies deemed to be most robust, the BB effect to reduce fracture risk was sustained (four studies, pooled ES = 0.79, 95% CI 0.67-0.94; I(2) = 96%). The risk of a hip fracture was lower in both women and men receiving BBs (women: pooled ES = 0.86, 95% CI 0.80-0.91; I(2) = 1% and men: pooled ES = 0.80, 95% CI 0.71-0.90; I(2) = 0%). Similar risk reductions were found for clinical vertebral and forearm fractures, although statistical significance was not reached. The reduction in risk did not appear to be dose-related (test for a linear trend p value 0.150). Using adjusted indirect comparisons, it was estimated that β1-selective agents were significantly more effective than nonselective BBs in reducing the risk of any fracture (six studies, β1-selective blockers vs. nonselective BBs: RE pooled ES = 0.82, 95% CI = 0.69-0.97).
conclusionsThe findings suggest that the risk of fracture is approximately 15% lower in patients treated with BBs compared to controls independent of gender, fracture site, and dose. This risk reduction might be associated with the effects of β1-selective blockers.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.