Bisphosphonates and risk of stroke: matched case control study

Godoy Caballero, Ana Luisa and Asghar, Zahid and Siriwardena, Niro and Windle, Karen and McKay, Steve and Grassby, Paul and Sharma, Jagdish (2015) Bisphosphonates and risk of stroke: matched case control study. In: SAPC Regional Conference, 17 March 2015, University of Nottingham.

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Item Type:Conference or Workshop contribution (Presentation)
Item Status:Live Archive

Abstract

Introduction: There is evidence stating that calcium, vitamin D or bisphosphonates may prevent fractures, but it is also believed that they may be associated with cardiovascular diseases. For calcium and vitamin D, there exists evidence showing an association with a higher incidence of cardiovascular diseases (CVD) including stroke. There is uncertainty about the cardiovascular risks associated to bisphosphonates and concern about their safety. We aimed to investigate whether there is an association between bisphosphonate treatment and the risk of stroke.
Methods: We used a matched 1:1 case-control design with data from the United Kingdom General Practice Research Database (GPRD). We compared cases, aged 18 years or above, either living or dead, with stroke during September 2001 to August 2009, with controls, matched for age, sex, calendar time and practice. Outcome measures were unadjusted and adjusted odds ratios and 95% confidence intervals for stroke associated with bisphosphonate treatment prior to the index date. We adjusted for disease groups, cardiovascular risk factors, treatments, GP consultations, home visits and IMD score.
Results: We included 26,784 cases of stroke with equal number of matched controls. Two thirds of them were 65 or older and there were similar number of females than males (51.5% females and 48.5% males). The unadjusted analysis showed an association of bisphosphonates uptake with stroke (OR 1.14, 95% CI 1.07-1.22). However, the adjusted analysis did not find any link between bisphosphonate uptake and the risk of stroke (adjusted OR 1.00, 95% CI 0.92-1.09).
Conclusions: We did not find any association between stroke and bisphosphonate treatment. Bisphosphonates could be used as a substitute of other drugs for the treatment of osteoporosis, such as calcium or vitamin D that has already been shown to have an influence in the risk of stroke.

Keywords:case control study, bisphosphonates, stroke
Subjects:L Social studies > L510 Health & Welfare
Divisions:College of Social Science > School of Health & Social Care
ID Code:17240
Deposited On:22 Apr 2015 17:05

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