Association between beta-blocker use and fracture risk: the Dubbo Osteoporosis Epidemiology Study.
BACKGROUND
In animal model, mice treated with beta-blockers (BB) had increased bone mass. In humans, high bone mass is associated with reduce fracture risk. The present study sought to test the hypothesis that BB use is associated with reduced fracture risk.


METHODS
Data from 3488 participants (1285 men) aged 50 years and above in the Dubbo Osteoporosis Epidemiology Study (DOES) were analyzed. Baseline characteristics of participants were obtained at the initial visit which had taken place between 1989 and 1993. Bone mineral density (BMD) at the lumbar spine and femoral neck was measured by dual energy X-ray absorptiometry (GE-LUNAR Corp, Madison, WI). Two hundred and sixty two (20%) men and 411 (19%) women had been on BB, as ascertained by direct interview and verification with medication history. The incidence of fragility fractures was ascertained during the follow-up period (1989-2008).


RESULTS
In men, BB use was associated with higher BMD at the femoral neck (0.96 versus 0.92 g/cm², P < 0.01), higher lumbar spine (1.32 versus 1.25 g/cm², P < 0.01), and lower fracture risk than those not on BB (odds ratio [OR]: 0.49; 95% CI: 0.32-0.75). In women, BB users also had higher femoral neck BMD (0.83 versus 0.81 g/cm², P < 0.01), higher lumbar spine BMD (1.11 versus 1.06 g/cm², P < 0.01), and lower risk of fracture than non-users (OR 0.68, 95% CI: 0.53-0.87). The associations between BB use and fracture risk were independent of age, BMD, and clinical risk factors. Subgroup analysis suggested that the association was mainly found in selective BB, not in non-selective BB.


CONCLUSIONS
Beta-blockers use, particularly selective BB, was associated with reduced fracture risk in both men and women, and the association was independent of BMD.
Osteoporosis and Bone Biology Research, Garvan Institute of Medical Research, Australia.
Shuman
S
Yang
Nguyen D
ND
Nguyen
Jacqueline R
JR
Center
John A
JA
Eisman
Tuan V
TV
Nguyen
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D000368:Aged; D000818:Animals; D001315:Australia / Q000453:epidemiology; D015519:Bone Density / Q000187:drug effects; D005260:Female; D005272:Femur Neck / Q000187:drug effects / Q000503:physiopathology; D050723:Fractures, Bone / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D051379:Mice; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors
D000319:Adrenergic beta-Antagonists