Previous studies have shown increased bone density and reduced risk of fracture in patients taking thiazide diuretics. In vitro, a direct effect of thiazides on osteoblasts has been reported. However, the long-term effects of low-dose thiazides on mineral metabolism have not been reported in normal subjects. The authors of this study [1] conducted a randomized, double-blinded trial in normal subjects aged 60 to 79 years, using hydrochlorothiazide 12.5 or 25 mg/d or placebo for 3 years. Subjects were encouraged to maintain calcium intake of 1 to 1.5 g/day. Measurements of serum and urine calcium metabolism were done at baseline, 6 months, and yearly. Data were analyzed in 88 men and 177 women who had taken study medication. Adjusted changes in the measurements from baseline to 1 and 3 years were compared among groups.

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Despite the sexual dimorphism of bone, hip fracture risk is very similar in men and women at the same absolute bone mineral density (BMD). A recent study was conducted with the objective of elucidating the main structural properties of bone that underlie the measured BMD and that ultimately determine the risk of hip fracture in elderly men and women [1]. This study is part of the Rotterdam Study (a large prospective population-based cohort) and included 147 incident hip fracture cases in 4806 participants with DXA-derived hip structural analysis (mean follow-up, 8.6 y).
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