Background
Methods
Registries
Study cohort
Antihypertensive drugs
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C03A, Thiazides: hydrochlorthiazide, bendroflumethiazide/potassium
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C03C, Loop diuretics: furosemide, bumetanide
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C07, Beta-blockers: propanolol, sotalol, metoprolol, atenolol, bisoprolol, esmolol, labetolol, carvedilol
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C08, Calcium channel blockers: amlodipine, felodipine, isradipine, nifedipine, nimodipine, lercanidipine, verapamil, diltiazem
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C09A, ACE inhibitors: captopril, enalapril, lisinopril, ramipril, trandolapril
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C09B, ACE inhibitor/thiazide: enalapril/thiazide, lisinopril/thiazide, zofenopril/thiazide
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C09C, Angiotensin II receptor blockers: losartan, eprosartan, valsartan, irbesartan, candesartan, telmisartan, olmesartan medoxomil
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C09D, Angiotensin II receptor blockers/thiazide: losartan/thiazide, eprosartan/thiazide, valsartan/thiazide, irbesartan/thiazide, candesartan/thiazide, telmisartan/thiazide, olmesartan medoxomil/thiazide
Drug exposure
Statistical analysis
Ethics and approvals
Results
Total cohort | By sex | By birth cohort | |||||
---|---|---|---|---|---|---|---|
n = 906,422 | Women | Men | 1935-1944 | 1925–1934 | 1915–1924 | <1915 | |
n = 506,568 | n = 399, 854 | n = 397,761 | n = 294,952 | n = 183,967 | n = 29,742 | ||
Thiazide | 6.2 | 7.1 | 5.2 | 2.8 | 2.3 | 1.0 | 0.1 |
Loop diuretic | 17.9 | 19.4 | 15.9 | 5.0 | 7.1 | 5.3 | 0.5 |
Beta blocker | 29.8 | 28.6 | 31.3 | 12.1 | 11.6 | 5.8 | 0.3 |
Calcium channel blocker | 21.6 | 21.5 | 21.6 | 8.9 | 8.4 | 4.1 | 0.2 |
ACE inhibitor | 14.0 | 12.4 | 16.0 | 5.4 | 5.4 | 2.9 | 0.3 |
ACE inhibitor/Thiazide | 3.8 | 2.1 | 1.7 | 1.7 | 1.4 | 0.7 | <0.1 |
Angiotensin II receptor blocker | 16.5 | 16.8 | 16.1 | 7.9 | 6.0 | 2.4 | 0.1 |
Angiotensin II receptor blocker/Thiazide | 14.0 | 8.1 | 5.9 | 7.0 | 5.1 | 1.8 | 0.1 |
Hip fractures | Birth year | |||||||
---|---|---|---|---|---|---|---|---|
1935–1944 | 1925–1934 | 1915–1924 | <1915 | |||||
n | % | n | % | n | % | n | % | |
All (n = 39,938) | 4904 | 1.2 | 13,322 | 4.5 | 18,599 | 10.1 | 3153 | 10.6 |
Women (n = 28,883) | 3086 | 1.5 | 9269 | 5.6 | 13,982 | 11.8 | 2546 | 11.4 |
Men (n = 11,055) | 1818 | 0.9 | 4053 | 3.1 | 4577 | 7.0 | 607 | 8.3 |
Total cohort | By sex | By birth cohort | Attributable effect (%) | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Exposed person-days (DDD) | Women | Men | 1935–1944 | 1925–1934 | 1915–1924 | <1915 | |||||||||
n | SIR (CI) | n | SIR (CI) | n | SIR (CI) | n | SIR (C)I) | n | SIR (CI) | n | SIR (CI) | n | SIR (CI) | ||
Thiazide | 550 | 0.7 (0.6–0.7) | 441 | 0.7 (0.6–0.8) | 109 | 0.6 (0.5–0.8) | 61 | 0.7 (0.5–0.8) | 208 | 0.6 (0.6–0.7) | 258 | 0.7 (0.6–0.8) | 23 | 0.8 (0.5–1.2) | –0.6 |
Loop diuretic | 4752 | 1.0 (1.0–1.0) | 3422 | 1.0 (0.9–1.0) | 1330 | 1.1 (1.1–1.2) | 371 | 2.0 (1.8–2.3) | 1538 | 1.3 (1.2–1.3) | 2543 | 0.9 (0.8–0.9) | 300 | 0.7 (0.6–0.8) | 0.1 |
Beta blocker | 4074 | 0.7 (0.7–0.8) | 3010 | 0.8 (0.8–0.8) | 1064 | 0.7 (0.6–0.7) | 511 | 0.9 (0.9–1.0) | 1700 | 0.8 (0.8–0.8) | 1757 | 0.7 (0.6–0.7) | 106 | 0.6 (0.5–0.8) | –3.5 |
Calcium channel blocker | 5028 | 0.8 (0.8–0.8) | 3736 | 0.8 (0.8–0.8) | 1292 | 0.7 (0.7–0.8) | 642 | 1.0 (0.9–1.1) | 1982 | 0.8 (0.8–0.8) | 2234 | 0.7 (0.7–0.8) | 170 | 0.7 (0.6–0.8) | –3.4 |
ACE inhibitor | 3438 | 0.9 (0.9–1.0) | 2351 | 1.0 (0.9–1.0) | 1087 | 0.9 (0.8–0.9) | 410 | 1.3 (1.1–1.4) | 1389 | 1.1 (1.0–1.1) | 1512 | 0.8 (0.8–0.8) | 127 | 0.7 (0.6–0.9) | –0.6 |
ACE inhibitor/Thiazide | 662 | 0.7 (0.6–0.7) | 520 | 0.7 (0.6–0.8) | 142 | 0.5 (0.4–0.6) | 111 | 1.9 (0.8–1.2) | 264 | 0.7 (0.6–0.7) | 261 | 0.6 (0.5–0.6) | 26 | 0.9 (0.6–1.3) | –0.9 |
Angiotensin II receptor blocker | 2631 | 0.8 (0.7–0.8) | 2041 | 0.8 (0.8–0.8) | 590 | 0.7 (0.6–0.7) | 411 | 0.9 (0.8–1.0) | 1049 | 0.7 (0.7–0.8) | 1094 | 0.8 (0.7–0.8) | 77 | 0.8 (0.6–1.0) | –1.9 |
Angiotensin II receptor blocker/Thiazide | 2122 | 0.6 (0.6–0.6) | 1688 | 0.6 (0.6–0.7) | 434 | 0.5 (0.4–0.5) | 367 | 0.7 (0.6–0.7) | 915 | 0.6 (0.6–0.6) | 790 | 0.6 (0.5–0.6) | 50 | 0.6 (0.5–0.9) | –3.6 |
Total cohort | By sex | |||||
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Exposed person-days (14 days) | Women | Men | ||||
n | SIR (CI) | n | SIR (CI) | n | SIR (CI) | |
Thiazide | 16 | 0.9 (0.5–1.5) | 12 | 0.9 (0.5–1.6) | 4 | 0.8 (0.2–2.2) |
Loop diuretic | 104 | 1.5 (1.3–1.9) | 76 | 1.6 (1.2–2.0) | 28 | 1.5 (1.0–2.1) |
Beta blocker | 47 | 1.0 (0.7–1.3) | 32 | 1.0 (0.7–1.3) | 15 | 1.0 (0.6–1.6) |
Calcium channel blocker | 38 | 1.0 (0.7–1.4) | 30 | 1.1 (0.7–1.5) | 8 | 0.8 (0.3–1.5) |
ACE inhibitor | 29 | 1.0 (0.7–1.5) | 24 | 1.3 (0.8–1.9) | 5 | 0.5 (0.2–1.2) |
ACE inhibitor/Thiazide | 2 | 0.4 (0.1–1.6) | 2 | 0.6 (0.1–2.2) | 0 | – |
Angiotensin II receptor blocker | 11 | 1.0 (0.5–1.8) | 11 | 1.0 (0.5–1.8) | 0 | – |
Angiotensin II receptor blocker/Thiazide | 10 | 0.5 (0.2–0.9) | 8 | 0.5 (0.2–1.1) | 2 | 0.4 (0–1.4) |