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The effect of treatment with a thiazide diuretic for 4 years on bone density in normal postmenopausal women

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Abstract

Summary

We performed a 2-year extension of our previous 2-year randomized controlled trial of the effects of hydrochlorothiazide on bone mineral density. The improvements in bone density seen in the first 2 years were sustained throughout the extension study. Thiazides provide a further option in the prevention of postmenopausal bone loss.

Introduction

Thiazide diuretics reduce urinary calcium excretion and therefore might prevent osteoporosis. Previously we reported a 2-year randomized controlled trial of hydrochlorothiazide treatment in 185 postmenopausal women that showed positive benefits of hydrochlorothiazide on bone density. Here, we report the results of a 2-year extension to that study.

Methods

Of 185 healthy postmenopausal women, 122 agreed to continue in a double-blinded 2-year extension taking 50 mg hydrochlorothiazide or placebo daily. Measurements of bone density occurred every 6 months and of calcium metabolism at 2 and 4 years.

Results

The improvements in bone density seen in the first 2 years of the trial were sustained throughout the extension. There were significant between-groups differences in the change in bone density over 4 years at the total body (0.9%, P < 0.001), legs (1.0%, P = 0.002), mid-forearm (1.1%, P = 0.03), and ultradistal forearm (1.4%, P = 0.04). At the lumbar spine (0.9%, P = 0.76) and femoral neck (0.4%, P = 0.53) the between-groups differences did not reach statistical significance.

Conclusions

Hydrochlorothiazide produces small positive benefits on cortical bone density that are sustained for at least the first 4 years of treatment. They provide a further option in the prevention of postmenopausal bone loss, especially for women with hypertension or a history of kidney stones.

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Conflict of interest statement

All authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Medicine, University of Auckland, Auckland, New Zealand

    M. J. Bolland, R. W. Ames, A. M. Horne, B. J. Orr-Walker, G. D. Gamble & I. R. Reid

  2. Osteoporosis Research Group, Department of Medicine, University of Auckland, Private Bag 92 019, Auckland, 1020, New Zealand

    M. J. Bolland

Authors
  1. M. J. Bolland
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  2. R. W. Ames
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  3. A. M. Horne
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  4. B. J. Orr-Walker
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  5. G. D. Gamble
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  6. I. R. Reid
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Corresponding author

Correspondence to M. J. Bolland.

Additional information

This study was funded by the Health Research Council (HRC) of New Zealand.

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Bolland, M.J., Ames, R.W., Horne, A.M. et al. The effect of treatment with a thiazide diuretic for 4 years on bone density in normal postmenopausal women. Osteoporos Int 18, 479–486 (2007). https://doi.org/10.1007/s00198-006-0259-y

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  • DOI: https://doi.org/10.1007/s00198-006-0259-y

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