Use of organic nitrates and the risk of hip fracture: a population-based case-control study.

CONTEXT: Use of organic nitrates has been associated with increased bone mineral density. Moreover, a large Danish case-control study reported a decreased fracture risk. However, the association with duration of nitrate use, dose frequency, and impact of discontinuation has not been extensively stud...

Celý popis

Podrobná bibliografie
Hlavní autoři: Pouwels, S, Lalmohamed, A, van Staa, T, Cooper, C, Souverein, P, Leufkens, H, Rejnmark, L, de Boer, A, Vestergaard, P, de Vries, F
Médium: Journal article
Jazyk:English
Vydáno: 2010
_version_ 1826284841411280896
author Pouwels, S
Lalmohamed, A
van Staa, T
Cooper, C
Souverein, P
Leufkens, H
Rejnmark, L
de Boer, A
Vestergaard, P
de Vries, F
author_facet Pouwels, S
Lalmohamed, A
van Staa, T
Cooper, C
Souverein, P
Leufkens, H
Rejnmark, L
de Boer, A
Vestergaard, P
de Vries, F
author_sort Pouwels, S
collection OXFORD
description CONTEXT: Use of organic nitrates has been associated with increased bone mineral density. Moreover, a large Danish case-control study reported a decreased fracture risk. However, the association with duration of nitrate use, dose frequency, and impact of discontinuation has not been extensively studied. OBJECTIVE: Our objective was to evaluate the association between organic nitrates and hip fracture risk. METHODS: A case-control study was conducted using the Dutch PHARMO Record Linkage System (1991-2002, n = 6,763 hip fracture cases and 26,341 controls). Cases had their first admission for hip fracture, whereas controls had not sustained any fracture after enrollment. Current users of organic nitrates were patients who had received a prescription within 90 d before the index date. The analyses were adjusted for disease and drug history. RESULTS: Current use of nitrates was not associated with a decreased risk of hip fracture [adjusted odds ratio (OR) = 0.93; 95% confidence interval (CI) = 0.83-1.04]. Those who used as-needed medication only had a lower risk of hip fracture (adjusted OR = 0.83; 95% CI = 0.63-1.08) compared with users of maintenance medication only (adjusted OR = 1.17; 95% CI = 0.97-1.40). No association was found between duration of nitrate use and fracture risk. CONCLUSIONS: Our overall analyses showed that risk of a hip fracture was significantly lower among users of as-needed organic nitrates, when compared with users of maintenance medication. Our analyses of hip fracture risks with duration of use did not further support a beneficial effect of organic nitrates on hip fracture, although residual confounding may have masked beneficial effects.
first_indexed 2024-03-07T01:19:54Z
format Journal article
id oxford-uuid:8ff7987c-c02c-4fe3-a59b-e3dca798967b
institution University of Oxford
language English
last_indexed 2024-03-07T01:19:54Z
publishDate 2010
record_format dspace
spelling oxford-uuid:8ff7987c-c02c-4fe3-a59b-e3dca798967b2022-03-26T23:08:15ZUse of organic nitrates and the risk of hip fracture: a population-based case-control study.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8ff7987c-c02c-4fe3-a59b-e3dca798967bEnglishSymplectic Elements at Oxford2010Pouwels, SLalmohamed, Avan Staa, TCooper, CSouverein, PLeufkens, HRejnmark, Lde Boer, AVestergaard, Pde Vries, FCONTEXT: Use of organic nitrates has been associated with increased bone mineral density. Moreover, a large Danish case-control study reported a decreased fracture risk. However, the association with duration of nitrate use, dose frequency, and impact of discontinuation has not been extensively studied. OBJECTIVE: Our objective was to evaluate the association between organic nitrates and hip fracture risk. METHODS: A case-control study was conducted using the Dutch PHARMO Record Linkage System (1991-2002, n = 6,763 hip fracture cases and 26,341 controls). Cases had their first admission for hip fracture, whereas controls had not sustained any fracture after enrollment. Current users of organic nitrates were patients who had received a prescription within 90 d before the index date. The analyses were adjusted for disease and drug history. RESULTS: Current use of nitrates was not associated with a decreased risk of hip fracture [adjusted odds ratio (OR) = 0.93; 95% confidence interval (CI) = 0.83-1.04]. Those who used as-needed medication only had a lower risk of hip fracture (adjusted OR = 0.83; 95% CI = 0.63-1.08) compared with users of maintenance medication only (adjusted OR = 1.17; 95% CI = 0.97-1.40). No association was found between duration of nitrate use and fracture risk. CONCLUSIONS: Our overall analyses showed that risk of a hip fracture was significantly lower among users of as-needed organic nitrates, when compared with users of maintenance medication. Our analyses of hip fracture risks with duration of use did not further support a beneficial effect of organic nitrates on hip fracture, although residual confounding may have masked beneficial effects.
spellingShingle Pouwels, S
Lalmohamed, A
van Staa, T
Cooper, C
Souverein, P
Leufkens, H
Rejnmark, L
de Boer, A
Vestergaard, P
de Vries, F
Use of organic nitrates and the risk of hip fracture: a population-based case-control study.
title Use of organic nitrates and the risk of hip fracture: a population-based case-control study.
title_full Use of organic nitrates and the risk of hip fracture: a population-based case-control study.
title_fullStr Use of organic nitrates and the risk of hip fracture: a population-based case-control study.
title_full_unstemmed Use of organic nitrates and the risk of hip fracture: a population-based case-control study.
title_short Use of organic nitrates and the risk of hip fracture: a population-based case-control study.
title_sort use of organic nitrates and the risk of hip fracture a population based case control study
work_keys_str_mv AT pouwelss useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy
AT lalmohameda useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy
AT vanstaat useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy
AT cooperc useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy
AT souvereinp useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy
AT leufkensh useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy
AT rejnmarkl useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy
AT deboera useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy
AT vestergaardp useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy
AT devriesf useoforganicnitratesandtheriskofhipfractureapopulationbasedcasecontrolstudy