A new research reinforces the link between prolong use of ulcer drugs and increased hip fracture risk in postmenopausal women, mainly among smokers.

Ulcer drugs are actually proton pump inhibitors (PPIs) that can affect risk of fracture by changing osteoclast function, blocking absorption of calcium, and increasing gastrin secretion.

Even the FDA released a warning regarding the possible association between long-term use of PPI and hip fracture in May 2010 and demanded for more investigation.

For the study that appeared online in the British Medical Journal today, data from prospective cohort Nurses’ Health Study assessed by Hamed Khalili at the Massachusetts General Hospital, Boston and his colleagues to get information on dietary and lifestyle causes. The participants were assessed through questionnaires since 1982 at every 2 years.

PPIs use rose about 3 times between 2000 and 2008 among 79,899 study participants. Total hip fracture risk among those who took drugs for a minimum of 2 years was 2.02 incidents in every 1000 person years in comparison to 1.51 incidents in every 1000 person years among non-drug users.

For those who used the drug for over 2 years, the hip fracture risk was 35% greater. The link held up even after adjusting calcium intake, level of physical activity, body mass index and other medication use that may alter the risk, like corticosteroids, thiazide diuretics, bisphosphonates, and hormone substitution.

However, the risk revisits to standard for women who discontinued the drugs for a minimum of 2 years.

Moreover, researchers also found that the risk of fracture increased by over 50% for current smokers or past smokers. Such association was not found among women who never smoked. The study suggests that blockage of absorption of calcium from smoking may function with PPIs to raise risk of fracture.

The researchers concluded that using PPI regularly was linked to elevated hip fracture risk amongst postmenopausal women, with most powerful risk among individuals who used the medication for long or have a smoking history.