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    Association between beta-blocker use and fracture risk: The Dubbo Osteoporosis Epidemiology Study

    Bone. 2010 Nov 1. [Epub ahead of print]

    These authors studied 3488 participants aged 50 and above and demonstrated that users of beta-blockers had a higher BMD and a decreased fracture risk. The use of selective beta-blockade was responsible for most of the decreased fracture risk and in multivariate analysis this effect was found to be independent of changes in BMD.

    Authors: Yang S, Nguyen ND, Center JR, et. al

    INTRODUCTION: 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.

    MATERIALS AND METHODS: Data from 3488 participants (1285 men) aged 50years 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 0.92g/cm(2), P<0.01), higher lumbar spine (1.32 versus 1.25g/cm(2), 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 0.81g/cm(2), P<0.01), higher lumbar spine BMD (1.11 versus 1.06g/cm(2), 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.

    CONCLUSION: Beta-blockers use, particularly selective BB, was associated with reduced fracture risk in both men and women, and the association was independent of BMD.

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