Association of statins and risk of fractures in a military health system: a propensity score-matched analysis

Ann Pharmacother. 2014 Nov;48(11):1406-14. doi: 10.1177/1060028014545038. Epub 2014 Jul 28.


Background: Contradictory evidence exists regarding statin use and risk of osteoporotic fractures.

Objective: The study objective was to examine the effect of statins on fracture risk in a Military Healthcare System (MHS) with similar access and standard of health care for its beneficiaries.

Methods: This is a retrospective study of patients enrolled in an MHS encompassing the period from October 1, 2003, to March 1, 2010. Statin users were defined as those receiving a statin for ≥90 days in Fiscal Year 2005, whereas nonusers were defined as individuals not receiving a statin throughout the study period. A propensity score-matched cohort of statin users and nonusers was created using 42 variables. The outcomes were identified using ICD-9-CM codes in the follow-up period (October 1, 2006, to March 1, 2010). In all, 4 outcomes were examined: all fractures, femoral neck fractures, upper-extremity fractures, and lower-extremity fractures.

Results: Of 46 249 patients, 6967 pairs of statin users and nonusers were matched. Statin users had a lower risk of femoral neck fracture in comparison to nonusers (odds ratio=0.58, 95% CI=0.36-0.94) but similar risk of all fractures, lower-extremity fractures, and upper-extremity fractures.

Conclusions: In this cohort of patients managed in an MHS, statin use was associated with a lower risk of femoral neck fractures, but not all fractures, upper-extremity fractures, or lower-extremity fractures.

Keywords: fractures; hip fracture; observational studies; statin.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Female
  • Fractures, Bone / epidemiology*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects*
  • Male
  • Middle Aged
  • Military Personnel
  • Odds Ratio
  • Propensity Score
  • Retrospective Studies
  • Risk


  • Hydroxymethylglutaryl-CoA Reductase Inhibitors