Risk of XXXX among older people using antihypertensive drugs: a nationwide cohort study.

@entity1 @entity1289 @entity174 @entity173 @entity6662 @entity7206 @entity460 @entity65 @entity11502
BACKGROUND: Many @entity1 with a high risk of @entity173 have coexisting @entity65 . We aimed to examine associations between exposure to antihypertensive drugs and the risk of @entity173 among older @entity1 . METHODS: We conducted a cohort study of the 906,422 @entity1 born before 1945 and living in Norway in 2005. We obtained information on all prescriptions of antihypertensive drugs dispensed (the Norwegian Prescription Database) in 2004-2010 and the dates of primary @entity173 (the Norwegian Hip Fracture Registry) in 2005-2010. We compared the incidence rates of @entity173 during the time @entity1 were exposed and unexposed to antihypertensive drugs by calculating the standardized incidence ratio (SIR). RESULTS: Altogether, 39,938 @entity1 experienced a primary @entity173 (4.4  %). The risk of @entity173 was decreased among @entity1 exposed to @entity7206 (SIR 0.7, 95  % confidence interval (CI) 0.6-0.7), beta-blockers (SIR 0.7, 95  % CI 0.7-0.8), @entity460 channel blockers (SIR 0.8, 95  % CI 0.8-0.8), @entity11502 receptor blockers (SIR 0.8, 95  % CI 0.7-0.8), @entity1289 inhibitor/ @entity6662 combination products (SIR 0.7, 95  % CI 0.6-0.7) and @entity11502 receptor blocker/ @entity6662 combination products (SIR 0.6, 95  % CI 0.6-0.6). Use of loop diuretics and @entity1289 inhibitors (plain products) was associated with increased @entity174 risk in @entity1 born after 1924, and with decreased risk in those born before 1925. The protective associations were stronger among exposed @entity1 than among exposed @entity1 for all drugs except loop diuretics. The SIRs decreased with increasing age among exposed @entity1 , except for @entity7206 and @entity11502 receptor blockers. CONCLUSIONS: We found a reduced risk of @entity173 associated with overall use of most antihypertensive drugs, but an increased risk with loop diuretics and @entity1289 inhibitors among @entity1 younger than 80  years and in new users of loop diuretics. This may have great impact at the population level, because the use of antihypertensive drugs is widespread in @entity1 at risk of @entity173 . Clinical studies are needed to further explore these associations.
