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

Pouwels, S., Lalmohamed, A., van Staa, T., Cooper, C., Souverein, P., Leufkens, H.G., Rejnmark, L., de Boer, A., Vestergaard, P. and de Vries, F. (2009) Use of organic nitrates and the risk of hip fracture: a population-based case-control study [in special issue: ECTS 2009: 36th European Symposium on Calcified Tissues] Bone, 44, supplement 2, p.S397. (doi:10.1016/j.bone.2009.03.293). (PMID:20130070).

Record type: Article


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.

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e-pub ahead of print date: 23 May 2009
Published date: June 2009


Local EPrints ID: 72891
ISSN: 8756-3282
PURE UUID: fa5bd99b-30cf-4415-b060-c6b689cc02c0
ORCID for C. Cooper: ORCID iD

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Date deposited: 24 Feb 2010
Last modified: 18 Oct 2017 16:32

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Author: S. Pouwels
Author: A. Lalmohamed
Author: T. van Staa
Author: C. Cooper ORCID iD
Author: P. Souverein
Author: H.G. Leufkens
Author: L. Rejnmark
Author: A. de Boer
Author: P. Vestergaard
Author: F. de Vries

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