| アブストラクト | PURPOSE: Nitrates, commonly used antianginal medications, also have a beneficial effect on bone remodeling and bone density, particularly with intermittent use. However, their effect on fracture risk is not clear. We examined the relation of short-acting nitrate use (proxy for intermittent use) with the risk of hip fracture in a large cohort of older adults with ischemic heart disease. METHODS: Participants aged 60 years or more with ischemic heart disease and without a history of hip fracture from The Health Improvement Network, an electronic medical records database in the United Kingdom, were included. The association of incident (new) use of short-acting nitrate formulations (nitroglycerin sublingual/spray/ointment or isosorbide dinitrate injection/sprays) with incident (new-onset) hip fracture risk was examined by plotting Kaplan-Maier curves and calculating hazard ratios using Cox proportional hazards regression models. Competing risk by death was analyzed in separate analyses. RESULTS: Among 14,451 pairs of matched nitrate users and nonusers (mean age, 72 +/- 7.6 years, 41% women for each cohort), 573 fractures occurred during follow-up (257 nitrate users; 316 nonusers). Hip fracture risk was 33% lower among short-acting nitrate users compared with nonusers (hazard ratio, 0.67; 95% confidence interval, 0.53-0.85; P = .0008). Competing risk analysis by death did not change effect estimates. CONCLUSIONS: In this large population-based cohort of older adults with ischemic heart disease, we found a significant reduction in hip fracture risk with the use of short-acting nitrates (intermittent use). Future studies are warranted given the potential for nitrates to be potent, inexpensive, and readily available antiosteoporotic agents. |
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| ジャーナル名 | The American journal of medicine |
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| Pubmed追加日 | 2016/10/11 |
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| 投稿者 | Misra, Devyani; Peloquin, Christine; Kiel, Douglas P; Neogi, Tuhina; Lu, Na; Zhang, Yuqing |
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| 組織名 | Boston University School of Medicine, Mass. Electronic address: demisra@bu.edu.;Boston University School of Medicine, Mass.;Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth;Israel Deaconess Medical Center and Harvard Medical School, Boston, Mass.;Boston University School of Medicine, Mass; Massachusetts General Hospital,;Boston. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/27720852/ |
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