Diuretics associated with bone loss in older men

Older men who take loop diuretics, commonly prescribed drugs for heart failure and hypertension, appear to have increased rates of hip bone loss than men who are not taking this medication, according to a report in the April 14 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

“Loop diuretics are one of the most commonly prescribed medications among older adults,” the authors write as background information in the article. These medications increase the amount of calcium excreted in urine, potentially damaging bones over the long term. In observational studies, use of loop diuretics has been associated with an increased risk of hip and other fractures. “However, there is uncertainty as to whether this increased fracture risk is attributable to negative effects on bone mineral density, fall-related mechanisms (e.g., dizziness and orthostasis [low blood pressure when standing up]), or associated comorbidities [co-occurring illnesses].”

Lionel S. Lim, M.D., M.P.H., of Griffin Hospital, Derby, Conn., and colleagues studied 3,269 men age 65 and older (average age 72.7). At an initial examination between 2000 and 2002 and at a follow-up visit an average of 4.6 years later, the men answered questions about medication use and brought in containers for all medication taken during the past 30 days. Bone mineral density of the total hip and two subregions was measured.

A total of 84 men continuously used loop diuretics between the two time periods, 181 used them intermittently and 3,004 did not use them. After adjusting for other related factors, the average annual rate of decline in total hip bone mineral density was -0.33 percent in non-users, -0.58 percent in intermittent users and -0.78 percent among continuous users.

“Compared with rates of hip bone loss among non-users of diuretics, adjusted rates of loss were about two-fold greater among intermittent loop diuretic users and about 2.5-fold greater among continuous loop diuretic users,” the authors write. Findings were similar at the subregions of the hip.

“We conclude that loop diuretic use in older men in associated with increased rates of hip bone loss,” the authors write. Future research should address the underlying mechanisms, they note. “Our findings suggest that health care providers should take into account loop diuretic use when evaluating older men for risk factors for bone loss and fracture risk.”

Source: JAMA and Archives Journals

Related stories:

Hot climate could shut down plate tectonics
A new study of possible links between climate and geophysics on Earth and similar planets finds that prolonged heating of the atmosphere can shut down plate tectonics and cause a planet's crust to become locked in place.
Scientists shine new light on inflammatory diseases
Investigators at Hospital for Special Surgery have identified a new mechanism involved in the pathogenesis of inflammatory diseases such as rheumatoid arthritis. The mechanism may also shed some light on why gene therapy experiments that use adenoviruses to deliver genes to humans have run into problems. The study will appear online on March 16 in the journal Nature Immunology.
Depression linked to bone-thinning in premenopausal women
Premenopausal women with even mild depression have less bone mass than do their nondepressed peers, a study funded in part by the National Institute of Mental Health (NIMH), part of the National Institutes of Health (NIH), shows. The level of bone loss is at least as high as that associated with recognized risk factors for osteoporosis, including smoking, low calcium intake, and lack of physical activity.
Resveratrol found to improve health, but not longevity in aging mice on standard diet
Scientists have found that the compound resveratrol slows age-related deterioration and functional decline of mice on a standard diet, but does not increase longevity when started at middle age. This study, conducted and supported in part by the National Institute on Aging (NIA), part of the National Institutes of Health, is a follow-up to 2006 findings that resveratrol improves health and longevity of overweight, aged mice. The report confirms previous results suggesting the compound, found naturally in foods like grapes and nuts, may mimic, in mice, some of the effects of dietary or calorie restriction, the most effective and reproducible way found to date to alleviate age-associated disease in mammals.
Red wine ingredient wards off effects of age on heart, bones, eyes and muscle
Large doses of a red wine ingredient can ward off many of the vagaries of aging in mice who begin taking it at midlife, according to a new report published online on July 3rd in Cell Metabolism, a Cell Press publication. Those health improvements of the chemical known as resveratrol—including cardiovascular benefits, greater motor coordination, reduced cataracts and better bone density—come without necessarily extending the animals' lifespan.
Nanostructures improve bone response to titanium implants
Titanium implants were successfully introduced by P.-I. Brånemark and co-workers in 1969 for the rehabilitation of edentulous jaws. After 40 years of research and development, titanium is currently the most frequently used biomaterial in oral implantology, and titanium-based materials are often used to replace lost tissue in several parts of the body.
Washington's boyhood home found, but no hatchet
(AP) -- The archaeologists were delighted to at last find the remains of George Washington's boyhood home but got stumped when they looked for evidence of the cherry tree and rusty hatchet.
Small protein may have big role in making more bone and less fat
A small protein may have a big role in helping you make more bone and less fat, researchers say. "The pathways are parallel, and the idea is if you can somehow disrupt the fat production pathway, you will get more bone," says Dr. Xingming Shi, bone biologist at the Medical College of Georgia Institute of Molecular Medicine and Genetics.

News discussion:

Medicine & Health news