Low-Dose Diuretic To Preserve Bone Density in Older Adults. Ann Intern Med. 2000;133:I-30. doi: 10.7326/0003-4819-133-7-200010030-00004
Download citation file:
Published: Ann Intern Med. 2000;133(7):I-30.
As people get older, their bones become less dense. When this bone thinning becomes severe, it is called osteoporosis. Persons with osteoporosis are at high risk for fractures, which can be a particularly serious problem at older ages. Previous studies have found that thiazide diuretics, a type of water pill, may increase bone density and may decrease the risk for hip fractures. Studies of this effect of thiazide diuretics have been limited in several ways, however, such as small size and inclusion of persons who were taking these medicines for reasons other than their effect on bone density (for example, high blood pressure).
To determine the effect of hydrochlorothiazide, a commonly used thiazide diuretic, on bone density in older adults.
320 healthy adults 60 to 79 years of age with normal blood pressure (115 men and 205 women).
The researchers randomly assigned study participants to take hydrochlorothiazide, 12.5 milligrams per day; hydrochlorothiazide, 25 milligrams per day; or placebo. The placebo pills looked like hydrochlorothiazide pills but contained no active ingredient. Before starting the study medication and every 6 months thereafter for the next 3 years, study participants underwent a special test to measure bone density of the hip, spine, and total body. Patients also completed surveys and examinations that provided information on general health, health behaviors that included diet and exercise, the occurrence of fractures, bone metabolism, and potential side effects of the study medicines.
Three hundred nine of the 320 patients completed 3 years of the study. Bone density increased from baseline in patients who took hydrochlorothiazide compared with those who took placebo. In the total study group, bone density increased most in patients who took the higher dose of hydrochlorothiazide. The effects of thiazide were greater in women than in men. Side effects were relatively uncommon and occurred about equally in all three study groups.
This study was too small and too short to determine whether the favorable bone density results were also associated with fewer fractures.
Among healthy older adults, hydrochlorothiazide preserves bone density. Further studies are needed to determine whether hydrochlorothiazide also prevents fractures.
Summaries for Patients are a service provided by Annals to help patients better understand the complicated and often mystifying language of modern medicine.
Summaries for Patients are presented for informational purposes only. These summaries are not a substitute for advice from your own medical provider. If you have questions about this material, or need medical advice about your own health or situation, please contact your physician.
The summary below is from the full report titled “Low-Dose Hydrochlorothiazide and Preservation of Bone Mineral Density in Older Adults. A Randomized, Double-Blind, Placebo-Controlled Trial.” It is in the 3 October 2000 issue of Annals of Internal Medicine (volume 133, pages 516-526). The authors are AZ LaCroix, SM Ott, L Ichikawa, D Scholes, and WE Barlow.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Endocrine and Metabolism, Geriatric Medicine, Metabolic Bone Disorders.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only