Fracture Risk in Men With Congestive Heart Failure. Risk Reduction With Spironolactone

Objectives: The purpose of this study was to determine whether spironolactone use is associated with fractures in men with congestive heart failure (CHF). Background: In rats with aldosteronism, spironolactone preserves skeletal strength. However, in humans, the relationship of spironolactone to fractures is not known. Methods: The medical records of all male patients with CHF from 1999 to 2005 treated at the Veterans Affairs Medical Center, Memphis, Tennessee, were reviewed (n = 4,735). Odds ratios with 95% confidence intervals of having a fracture associated with spironolactone use were estimated using conditional logistic regression. Results: We identified 167 cases with a single-incident fracture and matched these by age and race to 668 control subjects without fractures. After adjustment for covariates, spironolactone use was inversely associated with total fracture (odds ratio: 0.575; 95% confidence interval: 0.346 to 0.955, p = 0.0324). Conclusions: The use of spironolactone is inversely associated with fractures in men with CHF.