Initiation of antihypertensive therapy is associated with an increased risk of hip fracture

Eija Lönnroos, Jenni Ilomäki, Renuka Visvanathan, J. Simon Bell

Research output: Contribution to journalArticleOtherpeer-review


Evaluation of: Butt DA, Mamdani M, Austin PC, Tu K, Gomes T, Glazier RH. The risk of hip fracture after initiating antihypertensive drugs in the elderly. Arch. Intern. Med. 172(22), 1739-1744 (2012). Previous research has identified an association between antihypertensive drugs, falls and fractures. Nearly all hip fractures are fall-related. However, little is known about the risk of hip fracture immediately after initiating an antihypertensive. Butt et al. conducted a self-controlled case series of newly treated community-dwelling older people with hypertension. The authors linked data from the Ontario Drug Benefit Program database to a series of administrative healthcare registers. There were 1463 hip fractures among the 301,591 newly treated hypertensive older people over a 10-year period. There was a 43% increased risk of hip fracture in the 45 days immediately after initiating an antihypertensive compared with the six 45-day control periods before and after treatment initiation (incidence rate ratio: 1.43; 95% CI: 1.19-1.72). The within-person study design minimized the possibility of confounding by indication, which often occurs in cohort and case-control studies. Initiating an antihypertensive may be a risk factor for hip fracture in community-dwelling older people with hypertension. 

Original languageEnglish
Pages (from-to)201-203
Number of pages3
JournalAging Health
Issue number2
Publication statusPublished - Apr 2013
Externally publishedYes


  • aged
  • antihypertensive drug
  • hip fracture
  • treatment initiation

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