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Thia7ide diuretics give no protection agaimt~

A study of over 9700 women aged ~ 65 years has revealed that thiazide diuretics provide no overall protective effect against fractures of all types. In addition. thiazide diuretics have only a small effect on bone mass and no effect on the risk of falls in older women. The latter is a reassuring finding since thiazide diuretics occasionally cause postural hypotension. leading to concerns that this class of drugs might increase the risk of falls. which are the major cause of fractures in older women.

Thiazide diuretics do preserve appendicular bone mass but the extent of the effect is small. The researchers estimate that 10 years of thiazide diuretic use preserves only about one-tenth of one SO in bone mass. Thus. the researchers conclude that doctors should not rely on thiazide diuretics to prevent fractures in older women. [See also Views & Reviews, this issue, p4] Cauley JA. Cummings SR. Seeley 00. Black D. Browner W. et aI. Effects of thiazide diuretic therapy on bone mass. fractures. and falls. Archives of Internal Medicine 118: 666-673. I May 1993 1001970611

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