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The study’s background information notes that osteoporosis and heart failure are concerns for many postmenopausal women. Half will experience fractures caused by osteoporosis, and by age 40, their overall risk for developing heart failure is one in five. Heart failure is often treated with diuretics, sometimes referred to as “water pills,” to remove excess water from the body, making it easier for the heart to pump blood. Physicians commonly prescribe “loop” diuretics, which are more rapid acting than other diuretics, to treat patients with hypertension and congestive heart failure, conditions that occur in many postmenopausal women.
While loop diuretics treat heart-related problems by eliminating excess water, they simultaneously promote elimination of calcium by the kidneys, which can increase bone loss and fracture. In some studies, excessive loss of calcium in urine, or a condition known as “hypercalciuria,” is associated with low bone mineral density, a risk factor for fractures.
Findings from the WHI study over an eight-year period indicate that short-term use of loop diuretics does not appear to be associated with changes in bone mineral density, falls or fractures in postmenopausal women. However, prolonged use – three or more years – may slightly increase fracture risks in this group. These findings were reported in the January 26 issue of Archives of Internal Medicine, a peer-reviewed journal produced by Journal of the American Medical Association.
Lead researchers of the study, Laura Carbone, MD,
UTHSC professor of medicine, and Karen C. Johnson, MD, MPH, UTHSC professor of
preventive medicine and principal investigator of the WHI study in
Falls and fractures of study participants ages 50 to 79 were recorded for an average of 7.7 years. At baseline and at year three of the study, bone mineral density was measured for 300 diuretic users and 9,124 non-users. Women who used loop diuretics at some point in their lives were not found to be at a significant risk for total fractures, hip fractures, clinical vertebral fractures and falls. But, women who had used loop diuretics for three years or longer had a slightly increased risk for fractures.
Dr. Johnson, the WHI principal investigator in
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