# THIAZIDE DIURETICS AND RATE OF BONE LOSS IN THE ELDERLY

> **NIH NIH R01** · KAISER FOUNDATION HEALTH PLAN OF WASHINGTON · 1993 · $400,210

## Abstract

Hip fractures are a disabling and costly public health problem in older
adults that are projected to nearly double in number by the year 2020; yet
available alternatives for preventive interventions remain severely
limited.  Use of thiazide diuretics has been consistently associated with
higher levels of bone density in cross-sectional studies and with a reduced
risk of hip fracture in several epidemiologic studies.  However, the
evidence from observational investigations is inconclusive because of the
many differences between thiazide users and non-users in non-randomized
studies.  The long-term objective of this research is to determine the role
of thiazide diuretic therapy in prevention of bone loss and fracture in
older adults aged 60-79 years.

A double blind, randomized controlled trial of the effect of low dose
thiazide diuretic therapy on rate of bone loss will be conducted in 270
normotensive elderly women and men who are not currently treated for high
blood pressure.  Older adults will be recruited from a population base of
approximately 53,100 HMO enrollees.  Women and men will eligible if they
are normotensive and not taking any anti-hypertensive medications, if their
bone density at the hip is between the 5th and 95th percentiles for their
sex and age group, and if they are basically in good health.  Eligible
adults will be randomized to one of three groups:  1) 25 mg/day if
hydrochlorothiazide; 2) 12.5 mg/day of hydrochlorothiazide; or 3) placebo.
The primary trial endpoint, bone mineral density, will be measured at the
hip, AP lumbar spine, and using whole body calcium techniques at baseline
and every 6 months for 3 years of follow-up using dual energy X-ray
absorptiometry.

Secondary aims of the proposed trial are:  1) to elucidate mechanisms by
prospectively determining the effects of low dose thiazide therapy on
indices of bone metabolism, and 2) to prospectively determine the short and
long-term effects of low dose thiazide therapy on cardiovascular risk
factors, incidence rates of falls and functional status in elderly persons.

If the results of this randomized trial confirm an effect of thiazide
diuretic therapy on preserving bone density in older adults, then the use
of thiazides may prove to be a safe, effective, low cost means of
preventing osteoporotic fractures in our growing older population.

## Key facts

- **NIH application ID:** 3121750
- **Project number:** 5R01AG009825-02
- **Recipient organization:** KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
- **SAM.gov UEI:** CXFPKGA7TQZ3
- **Principal Investigator:** Andrea Z. LaCroix
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 1993
- **Award amount:** $400,210
- **Award type:** 5
- **Project period:** 1992-09-30 → 1997-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/3121750

## Citation

> US National Institutes of Health, RePORTER application 3121750, THIAZIDE DIURETICS AND RATE OF BONE LOSS IN THE ELDERLY (5R01AG009825-02). Retrieved via MORVS 2026-10-25 from https://api.morvs.ai/grant/nih/3121750. Licensed CC0.

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