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Some Heart Failure Meds May Raise Fracture Risk in Women
Date:1/27/2009

p diuretics for more than three years, Johnson noted.

Women should ask their doctor which diuretic they are taking, because not all diuretics are loop diuretics, Johnson said. Women should also ask about their bone mineral density to determine whether they are at risk for osteoporosis and fractures, she said.

Dr. Jeffrey S. Berger, a cardiologist at Duke University Medical Center and an expert in women's heart health, doesn't think the study is definitive. He said the long-term use of loop diuretics could still result in an increased risk of fracture.

"One has to be careful when prescribing medications such as loop diuretics," Berger said. "Medications may have harmful side effects. It is important to keep patients on the medication for as short a time as they need to be on it."

Berger stressed that loop diuretics are effective and important drugs for heart patients. "They help a lot more than they harm," he said. "They are useful and they make people feel a lot better, especially those with bad heart failure."

Still, "this study should raise a red flag," Berger said. "One has to be mindful of potential side effects, in this case it's fractures with the long-term use of loop diuretics."

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, agreed that the study is not the last word on the subject.

"It is important to note that the dose of loop diuretics were not collected [in the study] and even among the women reported to have heart failure there was minimal use of guideline-recommended heart failure medications." Fonarow said. "As such, it is unlikely this study involved many patients on higher doses of loop diuretics or with moderate to severe heart failure."

That means that, "there is a need for further studies to determine if moderate- or high-dose loop diuretic use is associated with bone fractures and falls," Fonarow said.

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