Fracture risk in men with congestive heart failure risk reduction with spironolactone.
OBJECTIVE
The purpose of this study was to determine whether spironolactone use is associated with fractures in men with congestive heart failure (CHF).


BACKGROUND
In rats with aldosteronism, spironolactone preserves skeletal strength. However, in humans, the relationship of spironolactone to fractures is not known.


METHODS
The medical records of all male patients with CHF from 1999 to 2005 treated at the Veterans Affairs Medical Center, Memphis, Tennessee, were reviewed (n = 4,735). Odds ratios with 95% confidence intervals of having a fracture associated with spironolactone use were estimated using conditional logistic regression.


RESULTS
We identified 167 cases with a single-incident fracture and matched these by age and race to 668 control subjects without fractures. After adjustment for covariates, spironolactone use was inversely associated with total fracture (odds ratio: 0.575; 95% confidence interval: 0.346 to 0.955, p = 0.0324).


CONCLUSIONS
The use of spironolactone is inversely associated with fractures in men with CHF.
Carbone
Laura D
LD
Department of Veterans Affairs Medical Center, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.
Cross
Jessica D
JD
Raza
Syed H
SH
Bush
Andrew J
AJ
Sepanski
Robert J
RJ
Dhawan
Saurabh
S
Khan
Bilal Q
BQ
Gupta
Malini
M
Ahmad
Khurram
K
Khouzam
Rami N
RN
Dishmon
Dwight A
DA
Nesheiwat
Joseph P
JP
Hajjar
Mohammad A
MA
Chishti
Waqas A
WA
Nasser
Wael
W
Khan
Mehwish
M
Womack
Catherine R
CR
Cho
Tara
T
Haskin
Ashley R
AR
Weber
Karl T
KT
D000368:Aged; D050723:Fractures, Bone / Q000209:etiology*; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D012189:Retrospective Studies; D013148:Spironolactone / Q000627:therapeutic use*
D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone