Statins use associated with lower risk of fractures

09/22/05

CHICAGO – In a large study of elderly, predominately male veterans, statin use was associated with a 36 percent reduction in risk of fracture when compared with no lipid-lowering therapy, according to a study in the September 26 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Several biological mechanisms have been proposed to explain an association between statins and bone health, including reduced inflammation and promotion of new bone growth through improvements in small blood vessel function, according to background information in the article. Previous studies have shown an association between statin use and fracture reduction. However, most studies have been of populations of women even though many statin users are elderly men with heart disease. The authors suggest that assessing this relationship in a male population would be especially relevant.

Richard E. Scranton, M.D., M.P.H., of the Massachusetts Veterans Epidemiology Research and Information Center, Boston, and colleagues analyzed data from patients who received care in the V.A. health care system between January 1, 1998, and June 30, 2001 to compare the rate of bone fractures in individuals using statins versus those not taking statins. Information on individuals' health status, race, age and body mass index (BMI) as well as other medications that might be associated with bone fracture were included in the analysis. Of the 91,052 individuals included in the study, 28,063 were prescribed only statins, 2,195 were prescribed nonstatin lipid-lowering medications alone, and the remaining 60,794 were not prescribed any lipid-lowering medications during the period of the study.

"More than 28,000 of these individuals were using statins, making this study one of the largest to evaluate the association between statins and fractures," the researchers report. "The use of statins in this study was associated with a 36 percent reduction in fracture risk compared with no lipid-lowering therapy and a 32 percent risk reduction when compared with other lipid-lowering therapy. These findings did not deviate significantly after adjustment for various covariates, including BMI."

"In our large cohort of mostly male veterans, statin therapy was associated with a reduction in fractures," the authors conclude. Our study represents one of the largest studies to date of individuals receiving statins and the evaluation of fracture risk. Although we were limited in adjusting for all known confounders, this study provides additional information that fuels the debate of whether statins protect individuals against fractures. Further research is necessary to confirm or refute our findings."

(Arch Intern Med. 2005; 165: 2007-2012. Available pre-embargo to media at www.jamamedia.org.)

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