title: Spironolactone and risk of upper gastrointestinal events: population based case-control study.
abstract: OBJECTIVE
  To confirm and quantify any association between spironolactone and upper gastrointestinal bleeding and ulcers.
  
  
  METHODS
  Population based case-control study.
  
  
  METHODS
  A primary care information database in the Netherlands.
  
  
  METHODS
  All people on the database who were aged 18 or more between 1 January 1996 and 30 September 2003. Patients with a history of alcoholism or gastrointestinal cancer were excluded. Ten controls were matched to each case of gastroduodenal ulcer or upper gastrointestinal bleeding by age (year of birth), sex, and index date.
  
  
  METHODS
  The occurrence of an upper gastrointestinal event (bleeding or ulcers), adjusted for potential confounders with conditional logistic regression analysis.
  
  
  RESULTS
  Within the source population of 306 645 patients, 523 cases of gastric or duodenal ulcer or upper gastrointestinal bleeding were identified and matched to 5230 controls. Current use of spironolactone was associated with a 2.7-fold (95% confidence interval 1.2 to 6.0) increased risk of a gastrointestinal event.
  
  
  CONCLUSIONS
  The risk of gastroduodenal ulcers or upper gastrointestinal bleeding is significantly increased in patients using spironolactone.
authors.affiliation: Department of Medical Informatics, Erasmus MC, PO Box 1738, 3000 Rotterdam, Netherlands. k.verhamme@erasmusmc.nl
authors.forename: Katia
authors.initials: K
authors.lastname: Verhamme
authors.forename: Georgio
authors.initials: G
authors.lastname: Mosis
authors.forename: Jeanne
authors.initials: J
authors.lastname: Dieleman
authors.forename: Bruno
authors.initials: B
authors.lastname: Stricker
authors.forename: Miriam
authors.initials: M
authors.lastname: Sturkenboom
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004232:Diuretics / Q000009:adverse effects*; D004381:Duodenal Ulcer / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000009:adverse effects*; D010438:Peptic Ulcer Hemorrhage / Q000139:chemically induced*; D012307:Risk Factors; D013148:Spironolactone / Q000009:adverse effects*; D013276:Stomach Ulcer / Q000139:chemically induced*
chemical_list: D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone