The secondary analysis of a large randomized clinical trial in the US provided evidence of a beneficial effect of thiazide-type diuretic therapy in reducing hip and pelvic fracture risk compared with other antihypertensive medications. A total of 22 180 participants (mean [SD] age, 70.4 [6.7] years; 43.0% female) were followed for up to 8 years during masked therapy. After trial completion, 16 622 participants for whom claims data were available were followed for up to 5 additional years. During the trial, 338 fractures occurred. Participants randomized to receive chlorthalidone vs amlodipine or lisinopril had a lower risk of fracture on adjusted analyses (hazards ratio [HR], 0.79). Risk of fracture was significantly lower in participants randomized to receive chlorthalidone vs lisinopril (HR, 0.75) but not significantly different compared with those randomized to receive amlodipine (HR, 0.82). During the entire trial and posttrial period of follow-up, the cumulative incidence of fractures was nonsignificantly lower in participants randomized to receive chlorthalidone vs lisinopril or amlodipine (HR, 0.87) and vs each medication separately. Diuretics for hypertension treatment have long track record of cardiovascular protection. Source: http://jamanetwork.com/
氯噻酮降低骨折风险：对一个美国大型随机临床试验的二次分析提供了与其它降压药相比，噻嗪类利尿剂治疗降低髋部和骨盆骨折风险的证据。双盲治疗期间，共22180名参与者（平均[标准差]年龄，70.4 [6.7]岁; 43.0％为女性）被随访了长达8年。试验完成后，对16622名有索赔资料的参与者又追踪了长达5年。试验期间发生了338例骨折。经校正分析，与氨氯地平或赖诺普利相比，随机接受氯噻酮者骨折风险（风险比0.79）较低。与赖诺普利相比，随机接受氯噻酮者骨折风险（风险比0.75）显着降低，但与那些随机接受氨氯地平者相比差异（风险比0.82）无显着性。在试验中和试验后整个随访期间，随机接受氯噻酮与赖诺普利或氨氯地平者相比，与每种药物单独相比的骨折累积发生率降低（风险比0.87）均无显著性。利尿剂治疗高血压有长期的心血管保护作用的记录。来源：http://jamanetwork.com/
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