Do drugs affect the risk of hip fracture in elderly women?

The drugs prescribed for 280 women with hip fractures (mean age 83 years) were compared with those prescribed for 145 women controls (mean age 81 years) as recorded in a family practice age-sex register. Thirty-three percent of the fracture patients were taking diuretics compared with 24% of the controls (.10 greater than P greater than .05). Forty-six percent of these diuretics taken by the fracture group (compared with 40% taken by the controls) were either loop or potassium sparing diuretics in combination with another diuretic. Twenty-five percent of the controls (compared with 9% of the fracture patients) were taking nonsteroidal anti-inflammatory drugs (NSAIDs) (P less than .001). The greater use of NSAIDs by control subjects may be due to the small overlap between osteoporosis and osteoarthritis. No significant differences were found for digoxin, anti-hypertensive drugs, and those taking no drugs. Thirty percent of fracture patients were taking sedatives and hypnotics compared with 28% of controls. Within this category, 54% of the fracture patients and 80% controls were receiving drugs (mainly benzodiazepines) with half-lives longer than 24 hours. Thus, this population did not confirm a previously identified association between long-acting sedatives and the risk of fracture. As only 3.5% of fracture patients and 2.1% controls were receiving phenothiazines, a role for these drugs in hip fracture cannot be ruled out. In summary, hip fracture patients were slightly more likely to be taking diuretics and somewhat less likely to be taking NSAIDs than controls but there were no differences with respect to other drugs.