Observational studyBMJ open2015
Danish register-based study on the association between specific cardiovascular drugs and fragility fractures.
Observational study in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 6 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
27 citing papers in PubMed, 6 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Angiotensin Receptor Blocker is Associated with a Lower Fracture Risk: An Updated Systematic Review and Meta-Analysis.International journal of clinical practice · 2022Pooled it
- The Efficacy of Nitrates for Bone Health: A Systematic Review and Meta-Analysis of Observational and Randomized Controlled Studies.Frontiers in endocrinology · 2022Pooled it
- Thiazide Use and Fracture Risk: An updated Bayesian Meta-Analysis.Scientific reports · 2019Pooled it
- Thiazide Diuretics and the Incidence of Osteoporotic Fracture: A Systematic Review and Meta-Analysis of Cohort Studies.Frontiers in pharmacology · 2019Pooled it
- Thiazide diuretic usage and risk of fracture: a meta-analysis of cohort studies.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Pooled it
- Renin-angiotensin system inhibitors and risk of fractures: a prospective cohort study and meta-analysis of published observational cohort studies.European journal of epidemiology · 2017Pooled it
- Bone microarchitectural degradation in hypertensive patients: a population-based study.Archives of osteoporosis · 2026Article
- Risk factors for non-vertebral fractures in community-dwelling elderly: a 10-year follow-up study in New Zealand.Archives of osteoporosis · 2025Article
- S-Nitrosoglutathione Is Not a Substrate of OATP1B1, but Stimulates Its Expression and Activity.Biomolecules · 2025Article
- Incident Diuretic Use and Subsequent Risk of Bone Fractures: A Large Nationwide Observational Study of US Veterans.Mayo Clinic proceedings · 2024Observational
- Diuretics, SGLT2 inhibitors and falls in older heart failure patients: to prescribe or to deprescribe? A clinical review.European geriatric medicine · 2023Review
- Risk of Fracture After Bilateral Oophorectomy.JBMR plus · 2023Article
- Antihypertensive Drugs and Risk of Bone Fractures.Drugs & aging · 2022Review
- The Effects of Osteoporotic and Non-osteoporotic Medications on Fracture Risk and Bone Mineral Density.Drugs · 2021Review
- Risk of Stroke, Myocardial Infarction, and Death Among Patients With Retinal Artery Occlusion and the Effect of Antithrombotic Treatment.Translational vision science & technology · 2021Article
- The Risk of Falling and Consequences of Falling in Patients with Atrial Fibrillation Receiving Different Types of Anticoagulant.Drugs & aging · 2021Article
- Association between the Use of Angiotensin-Blocking Medications with Hip Fracture and Death in Older People.The Journal of frailty & aging · 2020Article
- Association of Receiving Multiple, Concurrent Fracture-Associated Drugs With Hip Fracture Risk.JAMA network open · 2019Article
- The Use of Medicines with Anti-cholinergic Properties and Their Health Impacts among Hospitalised Malaysian Geriatric Patients.The Malaysian journal of medical sciences : MJMS · 2019Article
- Impact of prescription drugs on second fragility fractures among US Medicare patients.Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2018Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether drugs used in treatment of cardiovascular diseases (CVD-drugs), including hypertension, increase the risk of fragility fractures in individuals above the age of 65 years.
designRetrospective nationwide cohort study.
settingDanish nationwide national registers.
participantsAll individuals in Denmark ≥ 65 years who used specified CVD-drugs in the study period between 1999 and 2012. MAIN OUTCOMES MEASURES: Time-dependent exposure to CVD-drugs (nitrates, digoxin, thiazides, furosemide, ACE inhibitors, angiotensin receptor antagonists, β-blockers, calcium antagonists and statins) was determined by prescription claims from pharmacies. The association between use of specific CVD-drugs and fragility fractures was assessed using multivariable Poisson regression models, and adjusted incidence rate ratios (IRRs) were calculated.
resultsOverall, 1,586,554 persons were included, of these 16.1% experienced a fall-related fracture. The multivariable Poisson regression analysis showed positive associations between fracture and treatment with furosemide, thiazide and digoxin. IRRs during the first 14 days of treatment were for furosemide IRR 1.74 (95% CI 1.61 to 1.89) and for thiazides IRR 1.41 (1.28 to 1.55); IRR during the first 30 days of treatment with digoxin was 1.18 (1.02 to 1.37).
conclusionsUse of furosemide, thiazides and digoxin was associated with elevated rates of fragility fractures among elderly individuals. This may warrant consideration when considering diuretic treatment of hypertension in elderly individuals.
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What OpenQuestion holds
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.