According to background information in the article, animal studies have suggested that the beta-blocker propranolol increases bone formation, but data are limited on any associated reduced risk of fracture in humans.
Raymond G. Schlienger, Ph.D., M.P.H., of the University of Basel, Switzerland, and colleagues examined the association between beta-blocker use, with or without use of thiazide diuretics, and bone fracture risk in men and women aged 30 to 79 years. Researchers analyzed data from the UK General Practice Research Database (GPRD). The study included 30,601 patients with a new fracture diagnosis between 1993 and 1999 and 120,819 controls, matched to cases on age and sex and other factors.
The researchers found that compared with patients who did not use either beta-blockers or thiazide diuretics, patients who used only beta-blockers (3 or more prescriptions, about six months or longer) had a 23 percent lower risk for fracture, a 20 percent lower risk for fracture with use of thiazides only (3 or more prescriptions), and for combined use of beta-blockers and thiazides, a 29 percent lower risk.
"In summary, the present large case-control analysis provides evidence that use of beta-blockers--alone or in combination with thiazide diuretics--is associated with a significantly decreased fracture risk. The association in long-term users was weaker in women than in men in the current study population. Although additional observational studies and controlled trials are needed to confirm these potentially important findings, many elderly patients with hypertension are at risk of developing osteoporosis, and they may potentially profit from positive effects of the relatively inexpensive beta-blockers and thiazide diuretics on fracture risk," the authors write.
(JAMA. 2004; 292: 1326-1332. Available post-embargo at www.jama.com.)
Editor's Note: Co-author Dr. Meier is the recipient of a grant from the Swiss National Science Foundation.
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