(HealthDay News) – Postmenopausal women are at a 35% increased risk of hip fractures if they regularly use proton pump inhibitors (PPIs), and that risk increases to more than 50% among women with a history of smoking, according to a study published online Jan. 31 in BMJ.

Hamed Khalili, MD, from the Massachusetts General Hospital in Boston, and colleagues prospectively followed 79,899 postmenopausal women enrolled in the Nurses’ Health Study who provided data on the use of PPIs biennially from 2000–2008. The main outcome measured was incident hip fracture.

The researchers documented 893 incident hip fractures during 565,786 person-years of follow-up. Among regular users of PPIs, the absolute risk of hip fracture was 2.02 events per 1,000 person-years, compared with 1.51 events per 1,000 person-years among nonusers. The risk of hip fracture among regular users for at least two years was 35% higher than for nonusers (age adjusted HR, 1.35), with longer use associated with significantly increasing risk (Ptrend<0.01); the associations remained significant after adjusting for multiple risk factors. Among current and former smokers, the multivariate HR for fracture was 1.51 (95% CI, 1.20–1.91), whereas there was no association among women who never smoked (multivariate HR, 1.06; 95% CI, 0.77–1.46).

“Chronic use of PPIs is associated with increased risk of hip fracture, particularly among women with a history of smoking,” write the authors.

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