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Effects of three years of low-dose thiazides on mineral metabolism in healthy elderly persons

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Abstract

Summary

In this clinical trial of 12.5 or 25 mg/day of hydrochlorothiazide, the urine calcium showed significant decreases from placebo in men at one year, but the effects had waned by 3 years. Serum bicarbonate was consistently greater in the thiazide than in the placebo groups throughout the three years. These effects could be beneficial to the skeleton.

Introduction

Previous studies have shown increased bone density and reduced risk of fracture in patients taking thiazide diuretics. The long-term effects of low-dose thiazides on mineral metabolism have not been reported in normal subjects.

Methods

We conducted a randomized, double-blinded trial in normals aged 60–79 years, using hydrochlorothiazide 12.5 or 25 mg/d or placebo for three years. Subjects were encouraged to maintain calcium intake of 1,000 to 1,500 mg/day. Measurements of serum and urine calcium metabolism were done at baseline, six months, and yearly. Data were analyzed in 88 men and 177 women who had taken study medication. Adjusted change in the measurements from baseline to one and three years were compared among groups.

Results

The calcium intake increased in all groups. Urine calcium per day was significantly lower in thiazide than placebo groups in men at one year but not at three years; in women the changes were not significantly different. Serum bicarbonate was higher in thiazide compared to placebo groups at one and three years. No changes were seen in serum calcium, phosphate, parathyroid hormone, sodium or magnesium.

Conclusions

The results suggest that both increased calcium availability from a hypocalciuric effect and reduction in acid-induced bone buffering could be mechanisms for the beneficial skeletal effects.

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Funding

National Institutes of Health (AG09825) and University of Washington Clinical Nutrition Research Unit, National Institutes of Health (P30 DK35816). The study medications were provided by Ciba-Geigy.

Conflicts of interest

None of the authors have any conflicts of interest.

Author information

Authors and Affiliations

  1. University of Washington, 1959 NE Pacific Street, P. O. Box 356426, Seattle, WA, 98195–6426, USA

    S. M. Ott

  2. Group Health Cooperative of Puget Sound, 1730 Minor Ave, 16th Floor, Seattle, WA, 98101, USA

    A. Z. LaCroix, D. Scholes & L. E. Ichikawa

  3. University of Washington, Box 357232, Seattle, WA, 98195–7232, USA

    K. Wu

Authors
  1. S. M. Ott
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  2. A. Z. LaCroix
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  3. D. Scholes
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  4. L. E. Ichikawa
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  5. K. Wu
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Corresponding author

Correspondence to S. M. Ott.

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Ott, S.M., LaCroix, A.Z., Scholes, D. et al. Effects of three years of low-dose thiazides on mineral metabolism in healthy elderly persons. Osteoporos Int 19, 1315–1322 (2008). https://doi.org/10.1007/s00198-008-0612-4

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  • DOI: https://doi.org/10.1007/s00198-008-0612-4

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