Fracture Risk From Loop Diuretics Small
Only Long-Term Users Show Increased Risk of Bone Fractures
Heart Failure, Falls, and Fractures continued...
But in women with heart failure, loop diuretics were associated with a slight reduction in fracture risk. This finding, however, could have been due to chance.
Carbone points out that most of the women in the study were getting adequate amounts of calcium in their diets, either through the foods they ate or through supplementation.
"We don't know if these findings apply to women who are not getting enough calcium," she says.
It is also not clear if the findings apply to men, who tend to eliminate more calcium in their urine than women do, she says.
At least one recent study in men suggested that loop diuretics may accelerate bone loss at the hip.
"Patients on loop diuretics do have a higher risk for fractures, but this study suggests that it is because they are in poorer health and not because of the drugs they take," she says.
Loop Diuretics Protective?
Mayo Clinic endocrinologist Robert Wermers, MD, says the study is encouraging, especially the finding in women with heart failure.
"Women with heart failure who took loop diuretics actually had a lower risk for fractures," he says. "This shows the importance of treating the disease."
He adds that clinicians treating heart failure patients and other frail, older populations need to recognize that they are at increased risk for falls and fractures.
"People who are medically frail are certainly at risk for falling and breaking a bone," he says. "In addition to giving medication, we really need to focus on fall prevention."