Chipping Away at Bone: Proton-Pump Inhibitors and Smoking

Proton-pump inhibitors (PPIs) suppress gastric acid production and, consequently, calcium absorption. Thus, long-term PPI use may reduce bone density and raise fracture risk. Using data from the Nurses' Health Study (NHS) and prior studies, investigators assessed the association between long-term PPI use and risk for hip fracture in postmenopausal women.

Among 80,000 women in the NHS (age range at entry, 30–55), PPI use rose from 7% in 2000 to 19% in 2008. Absolute risk for hip fracture was 2.0 events per 1000 person-years among regular PPI users and 1.5 events per 1000 person-years among nonusers. Adjusted for multiple factors (e.g., body-mass index, calcium intake, osteoporosis history, use of hormone therapy), risk for hip fracture among …